診療と新薬 Web|Medical Consultation & New Remedies Web
診療と新薬:
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診療と新薬 2016;53(5):371-378

当院におけるピモベンダン投与症例667例の後ろ向き検討

所沢ハートセンター 循環器科

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):371-378

Retrospective Analysis of 667 Cases Treated with Pimobendan in Our Institute

Tokorozawa Heart Center, Department of Cardiology

診療と新薬 2016;53(5):371-378

当院におけるピモベンダン投与症例667例の後ろ向き検討

所沢ハートセンター 循環器科

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):371-378

Retrospective Analysis of 667 Cases Treated with Pimobendan in Our Institute

Tokorozawa Heart Center, Department of Cardiology

当院では心不全の治療薬としてピモベンダンを,① 急性期から用い,② 原則として慢性期にも中止せず,③ NYHA Ⅰの軽症の段階でも用いており,④ 心室頻拍(VT)が出現した場合も必要があれば継続することとしている。今回,2010年から2015年の6年間に当院でピモベンダンが処方された患者667例について,診療録の記載内容に基づき後ろ向きに集計した。平均観察期間897±677日(約3.5年)の経過において,心臓死(心不全死や致死性不整脈,急性冠症候群による死亡)は4.5%(14/311例;慢性期での心不全死は4例),心不全再入院は9.4%(26/278例)であった。肝機能(総ビリルビン値,血清AST値,血清ALT値),腎機能(血清クレアチニン値),BNP値のいずれも有意に改善し,心不全症状(うっ血)が良好にコントロールされていることが推測された。有害事象による中止は10例(1.7%)であったが,そのうち心室頻拍による中止は2例に留まった。全体の約1/4(24.6%)を占める「駆出率の保たれた心不全(HFpEF)」の解析でも肝機能,BNP値の有意な改善が認められた。一方,血清クレアチニン値の軽微な悪化が認められたが,これは背景疾患の自然歴としての腎機能の悪化であることが推測された。ピモベンダンは高齢者のQOL向上や日常生活動作(ADL)の確保に寄与すると考えられ,HFpEFや透析例を含む心不全患者全体に対し大きなメリットがある薬物であると思われる。

Keyword:ピモベンダン,慢性期心不全,駆出率の保たれた心不全(HFpEF),カルシウム・センシタイザー,PDE3阻害作用

診療と新薬 2016;53(5):371-378

当院におけるピモベンダン投与症例667例の後ろ向き検討

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):371-378

Retrospective Analysis of 667 Cases Treated with Pimobendan in Our Institute

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診療と新薬 2016;53(5):379-381

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):379-381

Successful Treatment Using Negative-pressure Therapy for Deep Dissecting Hematoma due to Dermatoporosis

Division of Dermatology, Yokohama General Hospital

診療と新薬 2016;53(5):379-381

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):379-381

Successful Treatment Using Negative-pressure Therapy for Deep Dissecting Hematoma due to Dermatoporosis

Division of Dermatology, Yokohama General Hospital

The present case is that of an 84-year-old woman who had been using dabigatran (Prazaxa® Boehringer Ingelheim, Germany) for 6 months to prevent recurrence of a cerebral infarction. Two days before initial examination at our hospital, she sustained a bruise on her right lower leg, followed by gradual exacerbation of subcutaneous bleeding and partial swelling. She was therefore referred to our hospital for examination. Although computed tomographic imaging of the site revealed a subcutaneous hematoma, no clear hematoma was observed in the muscle layer. Based on these findings, she was diagnosed with deep dissecting hematoma. After removing the hematoma through a skin incision, we performed negative-pressure therapy (NPT) with the application of a basic fibroblast growth factor spray. Granulation tissue gradually formed. NPT was continued following a subsequent skin grafting. NPT has previously been performed as a treatment for skin ulcers and engraftment of skin. Currently, NPT allows for more certain and stable application of negative pressure, which has led to relatively short healing times.

Key words: dabigatran, negative-pressure therapy, deep dissecting hematoma, dermatoporosis

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):379-381

Successful Treatment Using Negative-pressure Therapy for Deep Dissecting Hematoma due to Dermatoporosis

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診療と新薬 2016;53(5):383-400

スウェーデンの事例から学ぶ耐性菌対策と抗菌薬使用量削減への取組み

ICHG研究会;,1)ICHG研究会,2)伊勢崎市民病院 医療安全管理室,3)成田赤十字病院 臨床検査科,4)兵庫県立こども病院 小児感染症科,5)医療法人社団大同会 ニュー琴海病院 検査室,6)日本赤十字社 長崎原爆病院 感染制御室,7)独立行政法人 国立病院機構 千葉医療センター 消化器科,8)特定医療法人頌徳会日野クリニック 皮膚科・アレルギー科,9)京都府立医科大学付属病院 臨床検査部・感染対策部,10)医療法人育和会 育和会記念病院 医療安全管理室,11)長崎みなとメディカルセンター 市民病院 呼吸器内科,12)独立行政法人国立病院機構 大阪医療センター 免疫感染症科,13)独立行政法人国立病院機構 富山病院 診療部・小児科,14)医療法人ヘブロン会大宮中央総合病院 特定健診科,15)特定医療法人沖縄徳洲会 静岡徳洲会病院 内科,16)国立病院機構 別府医療センター 臨床研究部,17)スコーネ大学病院 感染症科

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):383-400

診療と新薬 2016;53(5):383-400

スウェーデンの事例から学ぶ耐性菌対策と抗菌薬使用量削減への取組み

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PDF:950 KB

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診療と新薬 2016;53(5):401-412

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):401-412

Efficacy of Natamame Tea Containing Canavanine on the Nasal Condition and Halitosis in Healthy Japanese ― Two Randomized, Double-blind, Placebo-controlled Studies ―

1)JACTA (Japan Clinical Trial Association),2)OZ Clinic,3)Smile-Japan co., ltd.

診療と新薬 2016;53(5):401-412

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):401-412

Efficacy of Natamame Tea Containing Canavanine on the Nasal Condition and Halitosis in Healthy Japanese ― Two Randomized, Double-blind, Placebo-controlled Studies ―

1)JACTA (Japan Clinical Trial Association),2)OZ Clinic,3)Smile-Japan co., ltd.

Objectives: Two clinical studies were done to investigate the efficacy of daily ingestion of "Natamame Tea" containing Canavanine on the nasal condition and halitosis.
Methods: Both studies were performed as randomized, placebo-controlled, double-blind trials for 12 weeks.
Results: As the primary outcome, the study showed significant differences in the subjective assessment on the nasal condition and halitosis. On the other hand, no significant differences were observed in the measurement of causative substances of the halitosis. In addition, as the secondary outcome no abnormal change of safety had been triggered by the ingestion of test drink.
Conclusion: The ingestion of Natamame Tea by healthy people for 12 weeks contributed to the improvement of nasal condition centering on snivel and remediation of halitosis based on self-evaluation. In addition, no safety-related matter occurred during 12-week test period.

Key words: Natamame, Canavanine, nasal condition, halitosis

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):401-412

Efficacy of Natamame Tea Containing Canavanine on the Nasal Condition and Halitosis in Healthy Japanese ― Two Randomized, Double-blind, Placebo-controlled Studies ―

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PDF:379 KB

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診療と新薬 2016;53(5):413-419

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):413-419

The Effects of Coenzyme Q10 on Vital Sign And Symptoms in Healthy Women with Hypotension ― A Randomized Placebo-controlled Study ―

1)JACTA (Japan Clinical Trial Association) ,2)OZ Clinic,3)CLIQUE

診療と新薬 2016;53(5):413-419

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):413-419

The Effects of Coenzyme Q10 on Vital Sign And Symptoms in Healthy Women with Hypotension ― A Randomized Placebo-controlled Study ―

1)JACTA (Japan Clinical Trial Association) ,2)OZ Clinic,3)CLIQUE

Objective: Coenzyme Q10 is ubiquitous in the body of most animals. It is an essential cofactor in mitochondrial oxidative phosphorylation, and is necessary for adenosine triphosphate production. Coenzyme Q10 has the function which improves the balance of cardiac output and peripheral circulation. In this study, we examined the effect of Coenzyme Q10 on blood pressure, heart rate, skin surface temperature and subjective symptoms in healthy volunteers with hypotension.
Methods: A randomized, double-blind, placebo-controlled study was conducted on 32 women with hypotension. Subjects were randomly allocated to group A or B. Subjects in group A and B ingested Coenzyme Q10 and placebo for 12 weeks, respectively. As a primary outcome, blood pressure, heart rate, skin surface temperature, and subjective symptoms that arise from hypotension were evaluated in each group. Safety was also evaluated based on a diary kept by the subjects.
Results: A total 29 subjects completed the study. There were significant differences in the amount of change in systolic blood pressure, skin surface temperature, and dizziness scores between group A and B. No adverse events were observed.
Conclusion: Daily ingestion of Coenzyme Q10 showed a favorable effect on systolic blood pressure, skin surface temperature, and dizziness without any adverse events.

Key words: coenzyme Q10, hypotension, low blood pressure

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):413-419

The Effects of Coenzyme Q10 on Vital Sign And Symptoms in Healthy Women with Hypotension ― A Randomized Placebo-controlled Study ―

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PDF:355 KB

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診療と新薬 2016;53(5):420-424

特許技術使用美容液の肌改善効果

1)一般財団法人 日本臨床試験協会(JACTA),2)日本橋エムズクリニック,3)株式会社フェース,4)株式会社フェース

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):420-424

Skin Enhancement Efficacy of Serum with Patent Technology

1)JACTA (Japan Clinical Trial Association),2)Nihonbashi M's Clinic,3)Chief Operating Officer FAITH CO., LTD.,4)Director, Executive Vice President FAITH CO., LTD.

診療と新薬 2016;53(5):420-424

特許技術使用美容液の肌改善効果

Shinryo to Shinyaku (Med Cons New-Remed)2016;53(5):420-424

Skin Enhancement Efficacy of Serum with Patent Technology

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PDF:432 KB

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