This study aimed to assess and compare effectiveness of Autofluorescence imaging (AFI) in diagnosis of early gastric cancer (EGC) between experienced and less experienced endoscopists. Fifty selected images (20 neoplastic lesions and 30 benign lesions/areas) of both white light endoscopy (WLE) and AFI were blindly reviewed by two groups; first consisted of five experienced endoscopists and second included five less experienced endoscopists. Sensitivity, specificity, and accuracy were 70%, 78%, and 75%, respectively, for AFI and 81%, 76%, and 78%, respectively, for WLE in the experienced group. In the less experienced group, sensitivity, specificity and accuracy were 80%, 81% and 80%, respectively, for AFI and 65%, 77%, and 72%, respectively, for WLE. Interobserver variability for the less experienced group was better with AFI than WLE. AFI improved sensitivity of endoscopic diagnosis of neoplastic lesions by less experienced endoscopists, and its use could beneficially enhance the clinical effectiveness of EGC screening.
Development of the sulfoconjugating activities for amine, alcoholic and phenolic compounds was studied in hepatic 105,000 g supernatants of fetal and newborn rats. All activities in the fetus at the late stage of pregnancy were negligible or very low when compared with those of the adult female level. Amine and alcohol sulfoconjugating activities were low 2 days after birth, increased with age, and attained the adult female level 17 days after birth. In contrast, phenol sulfoconjugating activity was nearly half the level of adult female rats in the neonates 2 days after birth and was relatively constant before maturation. There were no sex-related differences in any of the activities in the immature rats, but in adult animals the activities for amine and alcohol were higher in the females than in the males; the opposite was observed for phenol sulfoconjugation.
Background This large-scale observational study on negative events in a real-world setting investigated Japanese patients with atrial fibrillation who were not on anticoagulants. This study aims to evaluate the incidence of ischemic stroke and bleeding events (intracranial hemorrhage, gastrointestinal bleeding, others) based on CHA2DS2-VASc scores in Japanese patients with atrial fibrillation who were not anticoagulated. Methods and Results We used health checkups and insurance claim data from a Japanese insurance organization. Altogether, 9733 atrial fibrillation patients were not prescribed anticoagulation during their follow-up periods. Patients' risk levels were defined by their CHA2DS2-VASc scores (range 0-≥3): Men with scores of 0, 1, or ≥2 and women with scores of 1, 2, or ≥3 were considered at low, intermediate, or high risk, respectively. Cox proportional hazards model was used to assess the association between the CHA2DS2-VASc-determined risk and the incidence of ischemic stroke and intracranial, gastrointestinal, and other bleeding. The mean 2.5-year follow-up revealed 143 ischemic strokes and 332 bleeding events. Annual event rates were 0.58% for ischemic stroke and 1.17% for total bleeding events. Annual incidence of ischemic stroke increased with elevated predicted risks based on CHA2DS2-VASc scores: 0.18% for low-risk, 0.44% intermediate-risk, and 1.29% high-risk groups (P<0.001 for trend). Annual incidences of total bleeding also increased with elevated predicted risks: 0.51% for low-risk, 1.28% intermediate-risk, and 2.02% high-risk groups (P<0.001 for trend). Conclusions Risks of ischemic stroke and bleeding events were high, particularly among those with high CHA2DS2-VASc scores.
characterized by a personal and often a family history of atopy.2Family history of atopic diseases need to be confirmed as major risk factors for asthma occurrence and persistence in children.3Aim: To determine whether or not asthma is related to family history of atopy in Indonesian children.Methods: This cross-sectional study included 358 children who attended the Harum Melati Clinic, Pringsewu, Lampung, Indonesia, from March 2017 to August 2019.The patient group comprised 261 asthmatic children and the control group comprised 97 non-asthmatic children.Information was collected concerning their familial history of atopy.Kendall Tau-b test was used to measure the strength and direction of association between two variables measured.Results: There were 316 children (88.3 %) had a family history of atopy and 42 children (11.7%) did not have a family history of atopy (11,7%).Asthma was reported in 65.9 % of children with a family history of atopy and 7 % of children without any family history of atopy.The statistical test showed that childhood asthma was correlated to family history of atopy (p < 0.038 and R= 0.110 ).
It has been suggested that non-fasting triglyceride (TG) concentrations may be useful in predicting various diseases. However, current epidemiological evidence focuses mainly on the effects of fasting TG concentrations. The aim of this study was to investigate the effect of fasting and non-fasting TG levels on new-onset hyperuricemia (HUA) in the general Japanese population. This is a population-based retrospective cohort study (ISSA-CKD study); it included 5,576 participants without HUA at baseline between 2008 and 2019. Participants were categorized into gender-specific tertile groups of serum TG levels: group 1 (< 83 mg/dL [0.94 mmol/l] in male and < 77 mg/dL [0.87mmol/l] in female), group 2 (83-129mg/dL [0.94–1.46mmol/l] in male and 77-114 mg/dL [0.87–1.29mmol/l in female), and group 3 (≥ 130mg/dL [1.47 mmol/l] in male and ≥ 115 mg/dL [1.30mmol/l] in female). Outcome of this study was new-onset HUA (serum uric acid > 7 mg/dL [0.42 mmol/l]). During the 5.4-year follow-up period, 552 male and 146 female participants developed new-onset HUA. Incidence rates (per 1,000 person-years) of HUA were 18.2 in group 1, 21.9 in group 2 and 31.0 in group 3 among male, and 2.1 in group 1, 4.0 in group 2 and 7.4 group 3 among female. These associations remained significant after adjustment for confounders (p trend < 0.0001 among male and 0.0004 for female). There was no clear difference in effect of non-fasting and fasting TG levels on the development of new HUA (P interaction = 0.546 for male and 0.886 for female). Non-fasting and fasting TG concentrations were significantly associated with new-onset HUA among general Japanese men and women.
<b><i>Introduction:</i></b> Non-fasting triglyceride (TG) concentrations are useful for predicting various diseases, but most epidemiological studies investigated the association between fasting TG concentrations and chronic kidney disease (CKD). This study aimed to examine the association between casual (fasting or non-fasting) serum TG concentrations and new-onset CKD in the general Japanese population. <b><i>Methods:</i></b> We conducted a population-based, retrospective cohort study using annual health checkup data of residents of Iki City, Nagasaki Prefecture, Japan. Between 2008 and 2019, participants without CKD (estimated glomerular filtration rate <60 mL/min/1.73 m<sup>2</sup> and/or proteinuria) at baseline were included. Casual serum TG concentrations were classified by sex as tertile 1 (men: <0.95 mmol/L; women: <0.86 mmol/L), tertile 2 (0.95–1.49 mmol/L; 0.86–1.25 mmol/L), and tertile 3 (≥1.50 mmol/L; ≥1.26 mmol/L). The outcome was incident CKD. Multivariable-adjusted hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model. <b><i>Results:</i></b> 4,946 participants (2,236 [45%] men and 2,710 [55%] women; 3,666 [74%] fasting and 1,182 [24%] non-fasting) were included in the present analysis. During an average follow-up of 5.2 years, 934 participants (434 men and 509 women) developed CKD. In men, the incidence rate (per 1,000 person-years) of CKD increased with an elevation in TG concentrations (tertile 1: 29.4, tertile 2: 42.2, and tertile 3: 43.3). This association was significant, even after adjustment for other risk factors of age, current smoking habits, current alcohol intake, exercise habits, obesity, hypertension, diabetes mellitus, hyper-low-density-lipoprotein cholesterolemia, and use of lipid-lowering therapy (<i>p</i> = 0.003 for trend). In contrast, in women, TG concentrations were not associated with incident CKD (<i>p</i> = 0.547 for trend). <b><i>Conclusion:</i></b> Casual serum TG concentrations are significantly associated with new-onset CKD in Japanese men in the general population.
<b><i>Introduction:</i></b> Evidence using real-world data is sparse regarding the effects of oral anticoagulants (OACs) among patients with kidney disease. The aim of this study was to investigate the effects of kidney disease on ischemic stroke (IS) or systemic embolism (SE) among patients taking OAC, using large-scale real-world data in Japan. <b><i>Methods:</i></b> This was a retrospective cohort study using claims data and health checkup data from health insurance associations in Japan, from January 2005 to June 2017. We enrolled 21,581 patients diagnosed with atrial fibrillation (AF). Of the total population, 11,848 (54.9%) patients were taking OAC. A Cox proportional hazards model was used to examine the effect of kidney disease on IS/SE with or without OAC. <b><i>Results:</i></b> During follow-up, 208 participants who were not taking OAC (mean follow-up 2.6 years) and 200 who were taking OAC (mean follow-up 3.0 years) experienced IS/SE. The % IS/SE incidence rates with and without kidney disease were 2.42/person-year and 0.63/person-year in the total population, 3.66/person-year and 0.76/person-year in the group without OAC use, and 1.52/person-year and 0.55/person-year in patients with OAC use, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) of kidney disease for IS/SE were high, irrespective of OAC, even after adjustment: adjusted HR 2.62 (95% CI: 1.72–3.99) without OAC and adjusted HR 2.03 (95% CI: 1.20–3.44) with OAC; <i>p</i> = 0.193 for interaction between no OAC and OAC. Although bleeding risk was also high for kidney disease irrespective of OAC use (HR 2.93 [95% CI: 2.27–3.77] in the total population, HR 3.08 [95% CI: 2.15–4.43] in the group without OAC, and HR 2.73 [95% CI: 1.90–3.91] in the group with OAC use), net clinical benefit indicated that the benefit of OAC use exceeded the risk of bleeding: HR 4.50 (95% CI: 0.76–8.23) among those with kidney disease and HR 0.35 (95% CI: 0.04–0.66) among those without kidney disease. <b><i>Conclusion:</i></b> Although we found that OAC use was effective and recommended for patients with AF, advanced kidney disease is still an independent risk factor for IS/SE, even in patients taking OAC. Physicians should be aware of this risk and strictly control modifiable risk factors, regardless of OAC use.
