Kobatake Hospital

Opportunistic infections (OIs) play a crucial role in the morbidity and mortality of HIV-infected individuals. Despite the increasing use of antiretroviral therapy, there remains a lack of comprehensive data on the incidence of OIs to provide a clearer national picture. Therefore, this systematic review and meta-analysis aim to determine the pooled incidence and identify the predictors of OIs among people living with HIV in Ethiopia. A systematic search was conducted across multiple electronic databases to identify relevant studies. The degree of heterogeneity across studies was assessed using the I 2 statistic. Subgroup analyses were conducted to explore sources of heterogeneity. A funnel plot and Egger's test were used to assess publication bias. Adjusted hazard ratio with 95% CI was used to assess the relationship between predictors and OIs occurrence. In total, 24 studies met the inclusion criteria and were analyzed. The pooled incidence rate of OIs among people living with HIV in Ethiopia was found to be 6.96 per 100 person-years (95% CI: 5.14-8.78) based on a random-effects model. The meta-analysis identified predictors of OIs among people living with HIV, including poor adherence (pooled AHR 1.42, 95% CI: 1.12, 1.80), CD4 count < 200 cells/mm3 (AHR 1.49, 95% CI: 1.25, 1.78), being bedridden (AHR 1.45, 95% CI: 1.10, 1.90), and advanced WHO clinical stage (AHR 1.57, 95% CI: 1.24, 1.98). The burden of OIs continues to be a major health concern among people living with HIV/AIDS. Low CD4 count, poor adherence to ART, being bedridden, and advanced clinical stage were significantly associated with the occurrence of OIs.

PurposeThe aim of this cohort study was to evaluate the development and progression of presbyopia and the status of dry eye-related symptoms from 2017 to 2020, to assess the impact of the COVID-19 pandemic.MethodsNear add power at 30 cm was measured in 339 participants aged between 40 and 55 from 2017 to 2021 at Japanese eye clinics. Regression analysis of near add power and age was analyzed to compare 2017 with later years up to the pandemic. The prevalence of dry eye-related signs and six common symptoms were compared.ResultsThe number and mean age (y) of participants were 183 (48.6±4.1) in 2017, 46 (51.3±7.5) in 2019, and 110 (49.2±3.7) in 2020–21, respectively. The mean progression rate of near add power (D/y) was 0.13 for 2017, 0.09 for 2019 (P = 0.028, vs 2017), and 0.08 for 2020–21 (P<0.001, vs 2017). The slope (rate of presbyopia progression) became flatter from 2017 to 2021 and the estimated near add power at the age of 40 increased from 2017 to 2020–2021, implicating presbyopia developed earlier and worsened during the study period. The 2017 values were comparable with previous studies described in 1922 and 2019. The standardized correlation coefficient between age and near add power was 0.816 for 2017, 0.671 for 2019 (P = 0.084, vs 2017), and 0.572 for 2020–21 (P<0.001, vs 2017). Multiple regression analysis revealed age and COVID-19 pandemic were significantly correlated with near add power. The prevalence of dryness irritation, and pain was greater in 2020–21 than in 2017 with no difference in the prevalence of eye fatigue, blurring, and photophobia. There was no difference in the prevalence of short tear break-up time and positive corneal staining among 2017, 2019 and 2020–21.ConclusionEstimated presbyopia developed earlier and progressed slower from 2017 to 2021, the COVID-19 pandemic. Stress and rapid digitalization related to strict infection control and quarantine might be contributing factors.

スギ花粉症に対する舌下免疫療法薬が2014年に発売されてから4シーズンが経過したが, 実臨床における診療の実態は不明な点が多い. 2016年, 2017年にも同様の調査を行い報告してきたが, 今回2018年花粉飛散シーズン後に, スギ花粉症に対する舌下免疫療法を開始してから1～4シーズン経過した患者431例を対象として, 服薬状況, 自覚的治療効果, 副反応, 治療満足度, 治療に伴う負担などについて自記式質問紙を用いたアンケート調査を行った. 年齢分布は10歳代と40歳代に二峰性の分布を示した. 自覚的効果については1シーズン目と比較して2シーズン目以降で治療効果を自覚していると回答した患者割合が高い傾向にあり, 治療効果を自覚するためには少なくとも2シーズンの治療継続が望ましい可能性が示唆された. 副反応については, 1シーズン終了群では23.4%の回答で認めたが2シーズン目以降は5.6%, 5.0%, 1.2%と減少する傾向が見られ, 1シーズン継続することができればそれ以降の治療継続に大きな影響を及ぼす可能性は低いと考えられた. 4シーズン目になると積極的に治療継続を希望しない患者がおり, 今後は治療の終了時期に関する検討が望まれる.

We here characterized 27 japonica rice cultivars grown in Heilongjiang province and evaluated the relationship among their iodine absorption curve, physical properties, and ratio of 13kDa prolamin. We developed the novel estimation formulae for ratio of 13kDa prolamin and overall hardness (H2) with the use of Aλmax and λmax.

Background and AimPatients requiring hemodialysis show high morbidity with hepatitis C virus (HCV) infection, but there are difficulties associated with interferon‐based therapies. Asunaprevir and daclatasvir could help patients with HCV genotype 1b because the drugs have a nonrenal metabolism and show good viral eradication. We evaluated the efficacy and safety of combined asunaprevir and daclatasvir therapy.MethodsThis was a multicenter prospective trial of patients with chronic hepatitis or compensated cirrhosis from HCV genotype 1b who had end‐stage renal disease requiring chronic hemodialysis. Asunaprevir and daclatasvir were administered orally (100 mg twice daily and 60 mg once daily, respectively) for 24 weeks. The primary end‐point was the proportion of patients achieving sustained virological response 12, defined as HCV RNA <15 IU/mL undetectable at 12 weeks after completion of asunaprevir and daclatasvir treatment.ResultsBetween December 2014 and December 2015, 23 dialysis patients were enrolled, and 22 patients completed the protocol therapy. Sustained virological response 12 rates were 91.3% (95% confidence interval: 72.0–98.9) in the intention‐to‐treat and 95.5% (95% confidence interval: 77.2–99.9) in the per‐protocol populations. Serum aminotransferase significantly decreased after initiation of asunaprevir and daclatasvir (P < 0.01), although the level was low at baseline. Asunaprevir and daclatasvir were well tolerated; however, one patient could not continue because of infective endocarditis and cerebral infarction.ConclusionsAsunaprevir and daclatasvir could help patients with chronic hepatitis C receiving hemodialysis. Close collaboration with dialysis physicians is important when treating these patients because hemodialysis carries life‐threatening risks.