Gifu Red Cross Hospital

BackgroundPersonality traits play crucial roles in the onset, manifestation, and course of schizophrenia and bipolar disorder (BD). Previous meta-analyses focusing on NEO personality traits in patients with schizophrenia and BD revealed distinct differences in specific personality traits between patients with schizophrenia and healthy controls and between patients with BD and healthy controls. However, direct comparisons of personality profiles between schizophrenia patients and BD patients have been limited, with existing studies often limited by relatively small sample sizes.MethodsTwo online databases (PubMed and Scopus) were searched systematically to identify relevant articles, including publications up to April 2024. A meta-analysis of five personality traits, namely, neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C), assessed by the NEO five-factor inventory, was performed in seven cohorts, including our patient samples, consisting of 768 patients with schizophrenia and 555 patients with BD.ResultsThere was no significant heterogeneity in the five personality traits among the seven studies (I2 = 0-53.8, P > .05), except for C (I2 = 77.1, P = 5.65 × 10-4). Our meta-analyses revealed significant differences in three personality traits (E, O, and A) between patients with schizophrenia and patients with BD (E: Hedges’ g = −0.40, P = 1.34 × 10−11; O: g = −0.22, P = 1.76 × 10−4; and A: g = −0.24, P = 3.73 × 10-5). Patients with schizophrenia had lower scores on E, O, and A than those with BD did. No significant differences in the other two traits, N and C, were observed between the groups (P > .05).ConclusionsOur findings suggest that schizophrenia patients and BD patients have distinct personality profiles and that schizophrenia patients have more pronounced personality profiles than BD do, despite their overlapping symptoms and genetic predispositions.

In patients with chronic hepatitis C, 8 weeks of glecaprevir and pibrentasvir (GLE/PIB) treatment for chronic hepatitis (non-cirrhosis) and 12 weeks for cirrhosis have been approved in Japan. However, whether 8 weeks of treatment for cirrhosis may reduce treatment efficacy has not been adequately investigated. This prospective, nationwide, multicenter cohort study enrolled 1275 patients with chronic hepatitis C who received GLE/PIB therapy. The effect of liver fibrosis and treatment periods on the efficiency of GLE/PIB therapy was investigated. The primary endpoint was the sustained virological response (SVR) rate in patients with chronic hepatitis (non-cirrhosis) and cirrhosis. The association between treatment periods and liver fibrosis on the SVR after 12 weeks of treatment rate was investigated. The SVR rates in patients with chronic hepatitis with 8 weeks of treatment, chronic hepatitis with 12 weeks of treatment, cirrhosis with 8 weeks of treatment, and cirrhosis with 12 weeks of treatment were 98.9% (800/809), 100% (87/87), 100% (166/166), and 99.1% (211/213), respectively, and were was not different among these groups (P = 0.4). GLE/PIB therapy for chronic hepatitis C had high efficacy regardless of liver fibrosis status and treatment periods. Periods of GLE/PIB therapy could be chosen with available modalities, and high SVR rates could be achieved regardless of the decision.

Acetaminophen causes volume-dependent hepatotoxicity; however, hepatotoxicity may also occur with acetaminophen administered at normal doses. We encountered a case of allergic liver damage in a 17-year-old girl receiving acetaminophen at a regular dose. The patient was diagnosed using the Roussel Uclaf Causality Assessment Method (RUCAM) and the diagnostic scale of the Digestive Disease Week Japan 2004 workshop. She tested positive for acetaminophen on a drug-induced lymphocyte stimulation test, and liver biopsy results confirmed the diagnosis of acetaminophen-induced liver injury. Despite administering acetaminophen at normal doses, hepatotoxicity may occur, which warrants further exploration.

We compared the predictive ability of the International Prognostic Index (IPI), a frequently used prognostic model for peripheral T-cell lymphoma (PTCL), with that of a type-specific prognostic model, the Prognostic Index for PTCL-U (PIT). We retrospectively analyzed 113 patients diagnosed with PTCL. The median age was 67 years (range, 16–88 years), 75 patients (66%) were male, and the most common disease type was PTCL, not otherwise specified (69%). With a median follow-up of 6.8 years (interquartile range, 2.7–9.9 years), 5-year survival rates for the four groups in IPI were 85%, 62%, 49%, and 13%, respectively. Similarly, 5-year survival rates for the four groups in PIT were 83%, 64%, 49%, and 19%, respectively. The area under the receiving operating characteristic curve for predicting mortality from PIT (0.725) was not significantly different from that from the IPI (0.685, P = 0.134). Multivariable analysis showed that performance status ≥ 2 (P < 0.0001) and extranodal lesions ≥ 2 (P = 0.029) were significantly associated with lower overall survival. The present study found no significant difference in prognostic ability between the IPI and PIT for PTCL, and both models appear useful as predictive models.

A relationship between IgA nephropathy (IgAN) and bacterial infection has been suspected. As IgAN is a chronic disease, bacteria that could cause chronic infection in oral areas might be pathogenetic bacteria candidates. Oral bacterial species related to dental caries and periodontitis should be candidates because these bacteria are well known to be pathogenic in chronic dental disease. Recently, several reports have indicated that collagen-binding protein (cnm)-(+) Streptococcs mutans is relate to the incidence of IgAN and the progression of IgAN. Among periodontal bacteria, Treponema denticola, Porphyromonas gingivalis and Campylobacte rectus were found to be related to the incidence of IgAN. These bacteria can cause IgAN-like histological findings in animal models. While the connection between oral bacterial infection, such as infection with S. mutans and periodontal bacteria, and the incidence of IgAN remains unclear, these bacterial infections might cause aberrantly glycosylated IgA1 in nasopharynx-associated lymphoid tissue, which has been reported to cause IgA deposition in mesangial areas in glomeruli, probably through the alteration of microRNAs related to the expression of glycosylation enzymes. The roles of other factors related to the incidence and progression of IgA, such as genes and cigarette smoking, can also be explained from the perspective of the relationship between these factors and oral bacteria. This review summarizes the relationship between IgAN and oral bacteria, such as cnm-(+) S. mutans and periodontal bacteria.

Little is known about the prevalence of pelvic organ prolapse (POP). We aimed to evaluate the prevalence of POP and identify its risk factors in Japan. This was a single-centre, cross-sectional study. We recruited Japanese women seen for a Pap smear from July 2018 through May 2019. After providing their informed consent, subjects were asked to complete questionnaires. Pelvic organ support was assessed using the POP quantification (POP-Q) system by an examiner. Logistic regression analyses were conducted to identify risk factors for POP. There were 1032 women aged 21 to 84years. The distribution of POP-Q stage was stage 0, 38.0%; stage I, 45.0%; stage II, 16.4%; stage III, 0.6%; and stage IV, 0%. Rates (95% confidence interval [CI]) of stage II or greater in each age group were 6.6% (2.4-10.8) in 20s-30s; 17.6% (13.3-21.9) in 40s; 17.1% (12.9-21.3) in 50s; 18.0% (12.6-23.4) in 60s; and 28.7% (19.6-37.9) in 70s and over. Multivariate analysis revealed the following risk factors for POP, with odds ratio (95% CI): body mass index [BMI] ≥ 25kg/m2, 1.63 (1.05-2.51); BMI < 18.5kg/m2, 0.40 (0.17-0.94); hysterectomy, 4.09 (1.55-10.80); ≥ 3 vaginal deliveries, 2.26 (1.19-4.28); and ≥ 1 cup of coffee per day, 0.63 (0.43-0.92). Among Japanese women undergoing routine gynaecological examinations, 17.1% (14.7-19.5) had POP-Q stage II or greater. Overweight, hysterectomy and ≥ 3 vaginal deliveries increased the risk for POP, whereas underweight and daily coffee consumption decreased it.

The Visian ICL (STAAR Surgical, Monrovia, CA, USA) might have advantages over other add-on intraocular lenses (IOLs), since the anteriorly vaulting shape prevents the attachment of the two IOLs, since the thickness is far thinner than other IOLs, and since the material is made from hydroxyethyl methacrylate and collagen collamer. Until now, there have been several studies on piggyback ICL implantation for the management of pseudophakic ametropia, but all studies were conducted in a single institution with a relatively small sample size (Chiou et al. 2001; Hsuan et al. 2002; Kojima et al. 2010; Eissa 2017; Eissa et al. 2017). Herein, we report the outcomes of piggyback ICL implantation in eyes having pseudophakic ametropia, conducted as a collaborative work of the Japan ICL Study Group. The protocol was registered with the University Hospital Medical Information Network Clinical Trial Registry (000029258) and was approved by the Institutional Review Board at Kitasato University. Thirty-five eyes of 28 consecutive patients [10 of men and 25 of women, mean age ± standard deviation, 61.4 ± 11.7 years, spherical equivalent, −2.79 ± 4.08 dioptre (D)] who underwent ICL implantation as a piggyback IOL at five major institutions (Kitasato University Hospital, Sanno Hospital, Kobe Kanagawa Eye Clinic, Nagoya Eye Clinic, and Sato Eye Clinic) between 2007 and 2017 were enrolled. We performed standard ICL implantation (Kojima et al. 2010). The toric and non-toric ICLs were implanted in 26 and nine eyes, respectively. Preoperatively, 1 day, 1 week, and at 1, 3, 6 and 12 months postoperatively, we assessed uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and the vault (from the ICL to the IOL). The target refraction was emmetropia or a similar refraction to that of the fellow eye to accomplish isometropia, which was individually determined with visual simulation. The detailed breakdown of the ICL version was V3 (four eyes), V4b (21 eyes) and V4c (KS-AP, 10 eyes). The number of eyes at each follow-up examination was 30 eyes at 1 week, 28 eyes at 3 months, 20 eyes at 6 months and 16 eyes at 1 year, postoperatively. The visual and refractive outcomes were summarized in Figure 1. The logarithm of the minimal angle of resolution (logMAR) CDVA significantly improved from 0.02 ± 0.25 preoperatively to −0.04 ± 0.23 postoperatively (Wilcoxon signed rank test, P = 0.002). Eighteen eyes (51%) showed no change in CDVA, 12 eyes (34%) gained 1 line, three eyes (9%) and two eyes (6%) lost one line. LogMAR UDVA also significantly improved from 0.77 ± 0.42 preoperatively to 0.24 ± 0.38 postoperatively (P < 0.001). In 21 eyes that the target refraction was emmetropia, 66% and 89% of eyes had UDVA of 20/20 or better and 20/40 or better, respectively. About 66% and 91% were within ±0.5 and 1.0 D of the attempted correction, respectively. Changes in manifest refraction from 1 day postoperatively to the final follow-up were −0.07 ± 0.77 D. The ICL vault was 1.44 ± 0.35 mm. Of the 35 eyes, one eye (3%) developed a considerable ICL dislocation, possibly due to zonular weakness after primary cataract surgery. In this eye, the ICL was extracted, and subsequent LASIK was performed. Another one eye (3%) developed posterior capsule opacification of the primary IOL requiring a Nd-YAG capsulotomy. No interlenticular opacification, significant intraocular pressure rise (>21 mmHg), pupillary block, iritis, cystoid macular oedema or other vision-threatening complications occurred. It should be noted that peripheral iridectomy or laser iridotomy was necessary only for conventional ICL (V3 and V4b) implantation, in order to prevent the occurrence of pupillary block. Although the ICL vault is high for phakic patients, it is clinically acceptable in terms of the safety, because the anterior chamber is deep in pseudophakic eyes. A further study is necessary to develop the ICL sizing nomogram in IOL-implanted eyes. In summary, our multicenter study showed that the piggyback ICL performed was good in all measures of the safety, efficacy, predictability and stability, suggesting that secondary ICL implantation as a piggyback IOL is a feasible surgical option for the management of pseudophakic ametropia.

BackgroundMajor depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce the burden on their caregivers. Thus, we predict that family psychoeducation has the potential to reduce the burden on the caregivers of patients with chronic MDD. In the present study, we aimed to investigate the effects of brief multifamily psychoeducation (BMP) on the mental health status of family members of patients with chronic MDD.MethodsWe conducted a clinical trial consisting of 49 chronic MDD patients and their families. Each family was randomly assigned to either the BMP intervention group or the control group. The intervention group received four BMP sessions, once every two weeks for eight weeks. The control group received one counseling session administered by a nurse. All patients received standard treatment administered by physicians. The primary outcome measurement was the Kessler Screening Scale for Psychological Distress (K6) score of family members at 16- weeks after the first BMP session. Secondary outcomes were depressive symptoms of both family members and patients at multiple time points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted.ResultsThere was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: − 0.63 to 2.98, P = 0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference = − 3.37, 95%CI -6.32 to − 0.43, P = 0.02) and improved family functioning at multiple time points (Role; 8 W, difference = − 0.13, 95%CI -0.26 to − 0.00, P = 0.04, Affective Responsiveness; 8 W, difference = − 0.24, 95%CI -0.43 to − 0.05, P = 0.01, 32 W, difference = − 0.22, 95%CI -0.41 to − 0.03, P = 0.02, Behavior Control; 16 W, difference = − 0.17, 95%CI -0.34 to − 0.00, P = 0.04).ConclusionsFour BMP sessions did not significantly reduce the psychological distress of family members of patients with chronic MDD.Trial registrationClinical Trials. gov NCT01734291, retrospectively registered (Registration date: November 21, 2012).

AimTo compare the clinical outcomes of posterior chamber phakic intraocular lens implantation with a central hole (Hole Implantable Collamer Lens (ICL), STAAR Surgical) for low-to-moderate myopia and for high myopia.MethodsThis multicentre retrospective case series comprised 351 eyes of 351 consecutive patients undergoing ICL implantation. Eyes were divided into groups based on preoperative degree of myopia: group 1; 57 eyes, manifest spherical equivalent less than −6 dioptres (D), and group 2; 294 eyes, −6 D or more. Safety, efficacy, predictability, stability and adverse events were compared preoperatively; and at 1 day, 1 week and 1, 3, 6 and 12 months postoperatively,ResultsUncorrected and corrected visual acuities were −0.17±0.14 and −0.21±0.10 logMAR in group 1, and −0.16±0.09 and −0.21±0.08 logMAR in group 2, 1 year postoperatively. In groups 1 and 2, 98% and 99% of eyes were within 1.0 D of the targeted correction. Manifest refraction changes of −0.12±0.34 D (group 1) and −0.18±0.43 D (group 2) occurred from 1 day to 1 year. ICL exchanges were necessary in two eyes (0.7%) in group 2. No vision-threatening complications occurred at any time.ConclusionsThe ICL performed well for the correction of both low-to-moderate myopia and high myopia throughout the 1-year observation period. The clinical outcomes of ICL implantation for low-to-moderate myopia are essentially equivalent to those for high myopia.