المؤلفون: Fujii, Tomoko, Mori, Takahiro, Komiyama, Jun, Kuroda, Naoaki, Tamiya, Nanako

المصدر: Archives of Osteoporosis ; volume 18, issue 1 ; ISSN 1862-3514

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Summary In an analysis of claims data from a city in Japan, male patients and patients with dementia were less likely to receive osteoporosis pharmacotherapy after hip fracture. Treatment initiation rate has improved between 2014 and 2017. Purpose Older adults with recent hip fractures are at a high risk of recurrent fractures. However, the post-fracture care gap has been reported globally. This study examines factors associated with pharmacotherapy non-initiation within 1 year after hip surgery. Methods Using medical and long-term care (LTC) claims, and LTC needs certification data in Tsukuba City, Japan, we identified individuals aged 65 years or older who had hip fractures with subsequent surgical procedures between October 1, 2014, and December 31, 2017. Patient (age, sex, dementia, and comorbidities) and health service–related characteristics (fiscal year, type of hospital, number of hospital beds, and admission to recovery phase rehabilitation wards) were examined. The association of these factors with non-pharmacotherapy for osteoporosis within 1 year after hip fracture using multivariable logistic models was analyzed. Results We identified 275 patients with hip fractures who did not receive pharmacotherapy pre-fracture. Forty percent of them received pharmacotherapy within 1 year of post-fracture. Male sex (odds ratio (OR) = 4.49 [2.14–9.44]) and dementia (OR = 1.90 [1.03–3.52]) were associated with no pharmacotherapy, whereas later fiscal year (OR = 0.64 [0.48–0.87]) and admission to rehabilitation wards (OR = 0.25 [0.14–0.46]) were associated with pharmacotherapy initiation within 1 year of post-fracture. Comorbidities were not associated with the initiation of pharmacotherapy. Conclusion Pharmacotherapy for osteoporosis was less likely to be initiated after a hip fracture in male patients and patients with dementia. These patients should be considered for pharmacotherapy because they are at high risk of recurrent fractures.

الإتاحة: https://doi.org/10.1007/s11657-023-01314-xTest

المؤلفون: Moreno, Rui, Rhodes, Andrew, Piquilloud, Lise, Hernandez, Glenn, Takala, Jukka, Gershengorn, Hayley B., Tavares, Miguel, Coopersmith, Craig M., Myatra, Sheila N., Singer, Mervyn, Rezende, Ederlon, Prescott, Hallie C., Soares, Márcio, Timsit, Jean-François, de Lange, Dylan W., Jung, Christian, De Waele, Jan J., Martin, Greg S., Summers, Charlotte, Azoulay, Elie, Fujii, Tomoko, McLean, Anthony S., Vincent, Jean-Louis

المصدر: Critical Care ; volume 27, issue 1 ; ISSN 1364-8535

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الوصف: The Sequential Organ Failure Assessment (SOFA) score was developed more than 25 years ago to provide a simple method of assessing and monitoring organ dysfunction in critically ill patients. Changes in clinical practice over the last few decades, with new interventions and a greater focus on non-invasive monitoring systems, mean it is time to update the SOFA score. As a first step in this process, we propose some possible new variables that could be included in a SOFA 2.0. By so doing, we hope to stimulate debate and discussion to move toward a new, properly validated score that will be fit for modern practice.

الإتاحة: https://doi.org/10.1186/s13054-022-04290-9Test

المؤلفون: Kameda, Shinya, Fujii, Tomoko, Ikeda, Junpei, Kageyama, Akira, Takagi, Toshishige, Miyayama, Naoki, Asano, Kengo, Endo, Arata, Uezono, Shoichi

المساهمون: Japan Society for the Promotion of Science

المصدر: BMC Nephrology ; volume 24, issue 1 ; ISSN 1471-2369

مصطلحات موضوعية: Nephrology

الوصف: Background Unfractionated heparin sodium and nafamostat mesylate have long been used as anticoagulants in continuous kidney replacement therapy (CKRT) where citrate is unavailable. This study aimed to determine whether heparin or nafamostat mesylate used during CKRT was associated with a longer filter life. Methods In this single-centre observational study, we included adult patients who required CKRT and used heparin or nafamostat mesylate for their first CKRT in the intensive care unit from September 1, 2013, to December 31, 2020. The primary outcome was filter life (from the start to the end of using the first filter). We used propensity score matching to adjust for the imbalance in patients’ characteristics and laboratory data at the start of CKRT and compared the outcomes between the two groups. We also performed restricted mean survival time analysis to compare the filter survival times. Results We included 286 patients, 157 patients on heparin and 129 patients on nafamostat mesylate. After propensity score matching, the mean filter life with heparin was 1.58 days ( N = 91, Standard deviation [SD], 1.52) and with nafamostat mesylate was 1.06 days ( N = 91, SD, 0.94, p = 0.006). Multivariable regression analysis adjusted for confounding factors supported that heparin was associated with a longer filter life compared with nafamostat mesylate (regression coefficient, days, 0.52 [95% CI, 0.15, 0.89]). The between group difference of the restricted mean filter survival time in the matched cohort was 0.29 (95% CI, 0.07–0.50, p = 0.008). Conclusion Compared to nafamostat mesylate, heparin was associated with one-third to one-half a day longer filter life. Trial registration Not applicable.

الإتاحة: https://doi.org/10.1186/s12882-023-03060-1Test

المؤلفون: Mori, Takahiro, Komiyama, Jun, Fujii, Tomoko, Sanuki, Masaru, Kume, Keitaro, Kato, Genta, Mori, Yukiko, Ueshima, Hiroaki, Matsui, Hiroki, Tamiya, Nanako, Sugiyama, Takehiro

المساهمون: Ministry of Health, Labour and Welfare

المصدر: Archives of Osteoporosis ; volume 17, issue 1 ; ISSN 1862-3522 1862-3514

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Summary Using the nationwide health insurance claims database in Japan, we estimated total annual medical expenditures for fragility hip fracture across the population at 329.2 billion yen (2.99 billion US dollars). Long-term care expenditures were not included. Fragility hip fracture imposes a considerable health economic burden on society in Japan. Purpose Fragility hip fracture imposes a substantial health economic burden on society globally. We aimed to estimate medical expenditures for fragility hip fracture using the nationwide health insurance claims database in Japan. Methods We included adults aged 60 and over without prior hip fracture who were admitted for fragility hip fracture (i.e., femoral neck or extracapsular) between October 2014 and October 2015 (13 months). Fragility hip fracture was identified through newly assigned disease codes for fracture and procedure codes associated with the fracture. As a proxy for medical expenditures per patient, incremental payments were calculated (i.e., the difference between the total payments 6 months before and after fragility hip fracture). The total payments included health insurance reimbursements and copayments for inpatient and outpatient services. Long-term care expenditures were not included in this study. Results We identified 142,361 individuals (28,868 male and 113,493 female) with fragility hip fracture. Mean medical expenditures for fragility hip fracture per patient were 2,550,000 yen (¥) (23,180 US dollars [$]; ¥110 = $1) in male and ¥2,494,000 ($22,670) in female patients, respectively. Total annual medical expenditures for fragility hip fracture across the population were 329.2 billion yen (2.99 billion US dollars): 67.96 billion yen (620 million US dollars) in male and 261.24 billion yen (2.37 billion US dollars) in female patients, respectively. Conclusion This is the first study to estimate medical expenditures for hip fracture using the nationwide health insurance claims database, which represents almost all health insurance ...

الإتاحة: https://doi.org/10.1007/s11657-022-01096-8Test

المؤلفون: Yamada, Keiko, Fujii, Tomoko, Kubota, Yasuhiko, Ikeda, Takaaki, Hanazato, Masamichi, Kondo, Naoki, Matsudaira, Ko, Kondo, Katsunori

المساهمون: Japan Society for the Promotion of Science, Ministry of Health, Labour and Welfare, Japan Science and Technology, Japan, Sasakawa Sports Foundation, Japan Health Promotion and Fitness Foundation, Chiba Foundation for Health Promotion and Disease Prevention, the 8020 Promotion Foundation, Japan, Niimi University, Japan, Meiji Yasuda Life Foundation of Health and Welfare, National Center for Geriatrics and Gerontology, Japan, Japan Agency for Medical Research and Development

المصدر: BMC Musculoskeletal Disorders ; volume 23, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الوصف: Background Urbanization and population aging may affect prevalence of chronic pain from various causes. This cross-sectional study aimed to investigate the prevalence of chronic musculoskeletal pain, including some subtypes, in independent Japanese older people, and whether population density and population aging rate explained prevalence and differences in pain levels between municipalities. Methods We analyzed data from 12,883 independent older people living in 58 municipalities who completed mailed questionnaires and did not need support for daily living. We identified three types of pain: “chronic musculoskeletal pain” lasting ≥ 3 months (overall and in each part of the body), “chronic widespread-type pain” in the spinal and peripheral area, and “chronic multisite pain” in at least three sites. The latter two were measured using new definitions. These types of pain are correlated with depressive symptoms and we therefore examined the construct validity of the definitions by comparing the Geriatric Depression Scale score. We also used analysis of covariance to compare the prevalence of these three types of pain between municipalities. Odds ratios, median odds ratios, and the municipal variance in prevalence of chronic musculoskeletal pain were estimated by Bayesian multilevel logistic regression analysis using the Markov Chain Monte Carlo method. Results The construct validity of the definitions of chronic widespread-type pain and chronic multisite pain was confirmed. The prevalence of the three types of pain (chronic musculoskeletal, widespread, and multisite pain) was 39.0%, 13.9%, and 10.3%, respectively. Chronic musculoskeletal pain showed a higher prevalence among older people and women. Individuals in underpopulated, suburban, or metropolitan areas tended to have more pain than those in urban areas, but this was not statistically significant (odds ratio [95% credible interval] 1.15 [0.86–1.51], 1.17 [0.93–1.43], 1.17 [0.94–1.46]). Population density and population aging rate did not explain the ...

الإتاحة: https://doi.org/10.1186/s12891-022-05694-yTest

المؤلفون: Fujii, Tomoko, Salanti, Georgia, Belletti, Alessandro, Bellomo, Rinaldo, Carr, Anitra, Furukawa, Toshi A., Luethi, Nora, Luo, Yan, Putzu, Alessandro, Sartini, Chiara, Tsujimoto, Yasushi, Udy, Andrew A., Yanase, Fumitaka, Young, Paul J.

المساهمون: Health Research Counsil of New Zealand, Sir Charles Hercus Health Research Fellowship

المصدر: Intensive Care Medicine ; volume 48, issue 1, page 16-24 ; ISSN 0342-4642 1432-1238

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الإتاحة: https://doi.org/10.1007/s00134-021-06558-0Test

المؤلفون: Egi, Moritoki, Ogura, Hiroshi, Yatabe, Tomoaki, Atagi, Kazuaki, Inoue, Shigeaki, Iba, Toshiaki, Kakihana, Yasuyuki, Kawasaki, Tatsuya, Kushimoto, Shigeki, Kuroda, Yasuhiro, Kotani, Joji, Shime, Nobuaki, Taniguchi, Takumi, Tsuruta, Ryosuke, Doi, Kent, Doi, Matsuyuki, Nakada, Taka-aki, Nakane, Masaki, Fujishima, Seitaro, Hosokawa, Naoto, Masuda, Yoshiki, Matsushima, Asako, Matsuda, Naoyuki, Yamakawa, Kazuma, Hara, Yoshitaka, Sakuraya, Masaaki, Ohshimo, Shinichiro, Aoki, Yoshitaka, Inada, Mai, Umemura, Yutaka, Kawai, Yusuke, Kondo, Yutaka, Saito, Hiroki, Taito, Shunsuke, Takeda, Chikashi, Terayama, Takero, Tohira, Hideo, Hashimoto, Hideki, Hayashida, Kei, Hifumi, Toru, Hirose, Tomoya, Fukuda, Tatsuma, Fujii, Tomoko, Miura, Shinya, Yasuda, Hideto, Abe, Toshikazu, Andoh, Kohkichi, Iida, Yuki, Ishihara, Tadashi, Ide, Kentaro

المصدر: Journal of Intensive Care ; volume 9, issue 1 ; ISSN 2052-0492

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الوصف: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, ...

الإتاحة: https://doi.org/10.1186/s40560-021-00555-7Test

المؤلفون: Mori, Takahiro, Crandall, Carolyn J., Fujii, Tomoko, Ganz, David A.

المصدر: Archives of Osteoporosis ; volume 16, issue 1 ; ISSN 1862-3522 1862-3514

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Summary Among hypothetical cohorts of older osteoporotic women without prior fragility fracture in Japan, we evaluated the cost-effectiveness of two treatment strategies using a simulation model. Annual intravenous zoledronic acid for 3 years was cost-saving compared with biannual subcutaneous denosumab for 3 years followed by weekly oral alendronate for 3 years. Purpose Osteoporosis constitutes a major medical and health economic burden to society worldwide. Injectable treatments for osteoporosis require less frequent administration than oral treatments and therefore have higher persistence and adherence with treatment, which could explain better efficacy for fracture prevention. Although annual intravenous zoledronic acid and biannual subcutaneous denosumab are available, it remains unclear which treatment strategy represents a better value from a health economic perspective. Accordingly, we examined the cost-effectiveness of zoledronic acid for 3 years compared with sequential denosumab/alendronate (i.e., denosumab for 3 years followed by oral weekly alendronate for 3 years, making the total treatment duration 6 years) among hypothetical cohorts of community-dwelling osteoporotic women without prior fragility fracture in Japan at ages 65, 70, 75, or 80 years. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life-year [QALY]) from the public healthcare and long-term care payer’s perspective over a lifetime horizon with a willingness-to-pay of ¥5 million (or $47,500) per QALY. Results In the base case, zoledronic acid was cost-saving (i.e., more effective and less expensive) compared with sequential denosumab/alendronate. In deterministic sensitivity analyses, results were sensitive to changes in the efficacy of zoledronic acid or the cumulative persistence rate with zoledronic acid or denosumab. In probabilistic sensitivity analyses, the probabilities of zoledronic ...

الإتاحة: https://doi.org/10.1007/s11657-021-00956-zTest

المؤلفون: Mori, Takahiro, Crandall, Carolyn J., Fujii, Tomoko, Ganz, David A.

المصدر: Archives of Osteoporosis ; volume 16, issue 1 ; ISSN 1862-3522 1862-3514

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Summary Using a Markov microsimulation model among hypothetical cohorts of community-dwelling older osteoporotic Japanese women with prior vertebral fracture over a lifetime horizon, we found that daily subcutaneous teriparatide for 2 years followed by weekly oral alendronate for 8 years was not cost-effective compared with alendronate monotherapy for 10 years. Purpose Teriparatide has proven efficacy in reducing osteoporotic fractures, but with substantial cost. We examined the cost-effectiveness of sequential teriparatide/alendronate (i.e., daily subcutaneous teriparatide for 2 years followed by weekly oral alendronate for 8 years) compared with alendronate monotherapy for 10 years among community-dwelling older osteoporotic women with prior clinical or morphometric vertebral fracture in Japan. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life year [QALY]) from the perspective of a single payer responsible for both public healthcare and long-term care. We assumed a lifetime horizon with a willingness-to-pay of ¥5million (or $47,500) per QALY in the base case. We modeled the cost of biosimilar teriparatide, which has been available since November 2019 in Japan, assuming the efficacy was the same as that of the brand version. Results In the base case, sequential teriparatide/alendronate was not cost-effective compared with alendronate monotherapy. In deterministic sensitivity analyses, sequential teriparatide/alendronate would become cost-effective with 85%, 50%, and 15% price discounts to teriparatide at ages 70, 75, and 80, respectively, compared to the current biosimilar cost. Otherwise, results were especially sensitive to changes that affected efficacy of teriparatide or alendronate. In probabilistic sensitivity analyses, the probabilities of sequential teriparatide/alendronate being cost-effective were 0%, 1%, and 37% at ages 70, 75, and 80, respectively. ...

الإتاحة: https://doi.org/10.1007/s11657-021-00891-zTest

المؤلفون: Yagi, Kosuke, Fujii, Tomoko

المصدر: Critical Care ; volume 25, issue 1 ; ISSN 1364-8535

مصطلحات موضوعية: Critical Care and Intensive Care Medicine

الإتاحة: https://doi.org/10.1186/s13054-021-03677-4Test