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https://www.readbyqxmd.com/read/28448950/promoting-innovation-in-small-markets-evidence-from-the-market-for-rare-and-intractable-diseases
#1
Toshiaki Iizuka, Gyo Uchida
In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, "neglected" tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases...
April 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28448596/prevalence-and-complications-of-hypouricemia-in-a-general-population-a-large-scale-cross-sectional-study-in-japan
#2
Masanari Kuwabara, Koichiro Niwa, Akira Ohtahara, Toshihiro Hamada, Satoshi Miyazaki, Einosuke Mizuta, Kazuhide Ogino, Ichiro Hisatome
BACKGROUNDS: Hypouricemia was reported as a risk factor for exercise-induced acute renal injury (EIAKI) and urinary stones. However, the prevalence of kidney diseases among hypouricemic subjects has not been evaluated. This study was conducted to clarify the prevalence of hypouricemia and the association of hypouricemia with kidney diseases by using a large-scale Japanese population data. METHODS: This study is a retrospective cross-sectional study at the Center for Preventive Medicine, St...
2017: PloS One
https://www.readbyqxmd.com/read/28448195/design-characteristics-of-the-corrona-japan-rheumatoid-arthritis-registry
#3
Hisashi Yamanaka, Mitsumasa Kishimoto, Dimitrios A Pappas, Jeffrey D Greenberg, Joel M Kremer, Yoshiya Tanaka
OBJECTIVES: The primary objective is to prospectively study the comparative safety and effectiveness of older and newer classes of nonbiologic DMARDs (Disease-modifying antirheumatic drugs), biologic DMARDs and targeted synthetic therapies approved for rheumatoid arthritis (RA) in a real-world patient population in Japan. METHODS: Prospective, multicenter, noninterventional, observational study across geographic distribution of both private and public institutions for patients with RA who are newly prescribed one of the following medications: (1) methotrexate; (2) anti-TNF biologic DMARDs; (3) non-TNF biologic DMARDs; and (4) approved JAK inhibitors at the time of enrollment into the registry...
April 27, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28445263/acupuncture-for-enhancing-early-recovery-of-bowel-function-in-cancer-protocol-for-a-systematic-review
#4
Yi-Hua Liu, Yang Ye, Jia-Bin Zheng, Xue-Qian Wang, Ying Zhang, Hong-Sheng Lin
BACKGROUND: Cancer patients undergoing surgical procedure often suffer from bowel dysfunction and postoperative ileus (POI). Cancer management for early recovery of bowel function is still a challenging topic. Acupuncture has been commonly used in a variety of gastrointestinal diseases. The aim of this study is to evaluate the effects of acupuncture therapy to reduce the duration of POI and enhance bowel function in cancer patients. METHODS: We will systematically screen all randomized controlled trials (RCTs) published through electronically and hand searching...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28438853/factors-associated-with-microalbuminuria-remission-in-patients-with-type-2-diabetes-importance-of-early-intervention-for-microalbuminuric-patients-tsugaru-study
#5
REVIEW
Norio Nakamura, Ikuyo Narita, Takeshi Fujita, Reiichi Murakami, Michiko Shimada, Masayuki Nakamura, Hiroshi Osawa, Hideaki Yamabe, Ken Okumura
AIM: The aim of this study was to clarify the rates of remission and progression for microalbuminuria in patients with type 2 diabetes (T2DM); and factors associated with remission and progression of diabetic nephropathy (DN). PATIENTS AND METHODS: T2DM patients with a urinary albumin excretion (UAE) rate of 30-300 mg/gCr who were attending the medical clinic in the Tsugaru region in Japan were enrolled into this prospective, observational study for 36 months (N=317)...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28438290/programmed-death-ligand-1-pd-l1-expression-and-tumor-microenvironment-implications-for-patients-with-oral-precancerous-lesions
#6
Takahiro Yagyuu, Kinta Hatakeyama, Mitsuhiko Imada, Miyako Kurihara, Yumiko Matsusue, Kazuhiko Yamamoto, Chiho Obayashi, Tadaaki Kirita
OBJECTIVES: Cancer immunoediting represents a relatively novel concept attempting to explain the process of tumor escape from the host immune system response. Here, we attempted to elucidate the role of programmed death ligand 1 (PD-L1), the tumor microenvironment, and tumor escape mechanisms that allow malignant transformation of oral precancerous lesions. MATERIALS AND METHODS: Patients with oral precancerous lesions managed at the Nara Medical University Hospital, Japan, (n=120) were enrolled in this study...
May 2017: Oral Oncology
https://www.readbyqxmd.com/read/28437512/dentist-practice-patterns-and-therapeutic-confidence-in-the-treatment-of-pain-related-to-temporomandibular-disorders-in-a-dental-practice-based-research-network
#7
Naoki Kakudate, Yoko Yokoyama, Futoshi Sumida, Yuki Matsumoto, Valeria V Gordan, Gregg H Gilbert, Ana M Velly, Eric L Schiffman
AIMS: To quantify the practice patterns of Japanese dentists in the management of pain related to temporomandibular disorders (TMD) and to identify specific characteristics that are significantly associated with the decision to perform occlusal adjustment for TMD-related pain. METHODS: A cross-sectional study was conducted consisting of a questionnaire survey of dentists affiliated with the Dental Practice-Based Research Network Japan (JDPBRN) (n = 148). Participants were asked how they diagnosed and treated TMD-related pain...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437472/socioeconomic-status-and-type-2-diabetes-complications-among-young-adult-patients-in-japan
#8
Mitsuhiko Funakoshi, Yasushi Azami, Hisashi Matsumoto, Akemi Ikota, Koichi Ito, Hisashi Okimoto, Nobuaki Shimizu, Fumihiro Tsujimura, Hiroshi Fukuda, Chozi Miyagi, Sayaka Osawa, Ryo Osawa, Jiro Miura
OBJECTIVE: To assess the relationship between socioeconomic status (SES) and complications of type 2 diabetes among young adults in Japan. DESIGN: A cross-sectional study. SETTING: Outpatient wards of 96 member hospitals and clinics of the Japan Federation of Democratic Medical Institutions. PARTICIPANTS: A total of 782 outpatients with type 2 diabetes (525 males, 257 females), aged 20-40 years as of March 31, 2012. After excluding 110 participants whose retinopathy diagnosis was in question, 672 participants were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28435142/clinical-drug-drug-interaction-evaluations-to-inform-drug-use-and-enable-drug-access
#9
Dinko Rekić, Kellie S Reynolds, Ping Zhao, Lei Zhang, Kenta Yoshida, Madhav Sachar, Micheline Piquette Miller, Shiew-Mei Huang, Issam Zineh
Clinical drug-drug interactions (DDIs) can occur when multiple drugs are taken by the same patient. Significant DDIs can result in clinical toxicity or treatment failure. Therefore, DDI assessment is an integral part of drug development and the benefit-risk assessment of new therapies. Regulatory agencies including the Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the Pharmaceuticals and Medical Devices Agency of Japan (PMDA) have made recommendations in their DDI guidance documents on various methodologies (in vitro, in silico and clinical) to assess DDI potential and inform patient management strategies...
April 20, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28432652/blood-ties-and-trust-a-comparative-history-of-policy-on-family-consent-in-japan-and-the-united-states
#10
Hiroyuki Nagai
Informed consent honors the autonomous decisions of patients, and family consent places importance on decisions made by their families. However, there is little understanding of the relationship between these two medical decision-making approaches. Both approaches exist in Japan as part of its truth disclosure policy. What is the status of family consent in the United States, from which Japan introduced informed consent? This paper compares the situation in the United States with that in Japan, where family consent has been combined with informed consent...
April 21, 2017: Monash Bioethics Review
https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#11
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28431935/diversity-changes-of-microbial-communities-into-hospital-surface-environments
#12
Rika Yano, Tomoko Shimoda, Reina Watanabe, Yasutoshi Kuroki, Torahiko Okubo, Shinji Nakamura, Junji Matsuo, Sadako Yoshimura, Hiroyuki Yamaguchi
Previous works have demonstrated considerable variability in hospital cleanliness in Japan, suggesting that contamination is driven by factors that are currently poorly controlled. We undertook 16S rRNA sequence analysis to study population structures of hospital environmental microbiomes to see which factor(s) impacted contamination. One hundred forty-four samples were collected from surfaces of three hospitals with distinct sizes ("A": >500 beds, "B": 100-500 beds, "C": <100 beds). Sample locations of two ward types (Surgical and Internal) included patient room bed table (multiple) (4BT), patient overbed table (multiple) (4OT), patient room sink (multiple) (4S), patient room bed table (single) (SBT), patient overbed table (single) (SOT), patient room sink (single) (SS), nurse desk (ND), and nurse wagon (NW)...
April 18, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28431508/association-between-cardiopulmonary-resuscitation-duration-and-one-month-neurological-outcomes-for-out-of-hospital-cardiac-arrest-a-prospective-cohort-study
#13
Masahiro Kashiura, Yuichi Hamabe, Akiko Akashi, Atsushi Sakurai, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
BACKGROUND: The duration of cardiopulmonary resuscitation (CPR) is an important factor associated with the outcomes for an out-of-hospital cardiac arrest. However, the appropriate CPR duration remains unclear considering pre- and in-hospital settings. The present study aimed to evaluate the relationship between the CPR duration (including both the pre- and in-hospital duration) and neurologically favorable outcomes 1-month after cardiac arrest. METHODS: Data were utilized from a prospective multi-center cohort study of out-of-hospital cardiac arrest patients transported to 67 emergency hospitals between January 2012 and March 2013 in the Kanto area of Japan...
April 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28430328/outcome-of-various-hydrophobic-acrylic-intraocular-lens-implantations-in-children-with-congenital-cataract
#14
Jaspreet Sukhija, Savleen Kaur, Jagat Ram, Sonam Yangzes, Siddharth Madan, Jitender Jinagal
PURPOSE: To evaluate performance of different intraocular lenses (IOLs) after cataract surgery in children aged less than 2 years with regards to rates of visual axis opacification (VAO). METHODS: This was a retrospective chart review of children <2 years of age undergoing cataract surgery with primary posterior capsulotomy, anterior vitrectomy, and IOL over a period of 5 years with minimum follow-up of 1 year at a tertiary care institute. Children with microphthalmos, persistent fetal vasculature, traumatic cataract, aphakia, secondary IOLs, or any other coexisting ocular disease were excluded...
April 13, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28429612/a-unique-database-for-gathering-data-from-a-mobile-app-and-medical-prescription-software-a-useful-data-source-to-collect-and-analyse-patient-reported-outcomes-of-depression-and-anxiety-symptoms
#15
Yoshinori Watanabe, Yoko Hirano, Yuko Asami, Maki Okada, Kazuya Fujita
A unique database named 'AN-SAPO' was developed by Iwato Corp. and Japan Brain Corp. in collaboration with the psychiatric clinics run by Himorogi Group in Japan. The AN-SAPO database includes patients' depression/anxiety score data from a mobile app named AN-SAPO and medical records from medical prescription software named 'ORCA'. On the mobile app, depression/anxiety severity can be evaluated by answering 20 brief questions and the scores are transferred to the AN-SAPO database together with the patients' medical records on ORCA...
April 21, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28429301/ethical-issues-related-to-the-promotion-of-a-100-msv-threshold-assumption-in-japan-after-the-fukushima-nuclear-accident-in-2011-background-and-consequences
#16
REVIEW
Toshihide Tsuda, Lena Lindahl, Akiko Tokinobu
PURPOSE OF REVIEW: This article describes the debates in Japan regarding the 100 mSv threshold assumption and ethical issues related to it, and explores the background to distorted risk information and absence of risk communication in Japan. Then we seek proper risk communication based on scientific evidence. RECENT FINDINGS: On March 11, 2011 an accident occurred at the Fukushima Daiichi Nuclear Power Plant due to the Great East Japan Earthquake. Since then a number of misunderstandings have become common in Japan as a result of public statements by the Japanese and local governments that have no basis in medical science or are contradictory to medical science...
April 20, 2017: Current Environmental Health Reports
https://www.readbyqxmd.com/read/28428449/current-status-and-outcomes-of-direct-oral-anticoagulant-use-in-real-world-atrial-fibrillation-patients%C3%A3-fushimi-af-registry
#17
Yugo Yamashita, Ryuji Uozumi, Yasuhiro Hamatani, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Satoshi Morita, Masaharu Akao
BACKGROUND: The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status...
April 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28427784/prehospital-removal-improves-neurological-outcomes-in-elderly-patient-with-foreign-body-airway-obstruction
#18
Yutaka Igarashi, Shoji Yokobori, Yudai Yoshino, Tomohiko Masuno, Masato Miyauchi, Hiroyuki Yokota
OBJECTIVE: In Japan, the number of patients with foreign body airway obstruction by food is rapidly increasing with the increase in the population of the elderly and a leading cause of unexpected death. This study aimed to determine the factors that influence prognosis of these patients. METHODS: This is a retrospective single institutional study. A total of 155 patients were included. We collected the variables from the medical records and analyzed them to determine the factors associated with patient outcome...
April 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28422361/risks-of-thromboembolism-associated-with-hormone-contraceptives-in-japanese-compared-with-western-women
#19
Takao Kobayashi, Kazuko Sugiura, Toshiyuki Ojima
We extracted 581 thromboembolic events associated with combined oral contraceptives (COC) that occurred between 2004 and 2013 in Japan, from the Pharmaceuticals and Medical Devices Agency database. The most common thromboembolic events associated with COC were deep vein thrombosis, pulmonary embolism and their combination. The reported thromboembolic events increased year by year, in association with an increase in the quantity of prescribed low-dose estrogen progestin after approval for health insurance coverage for dysmenorrhea in 2008 in Japan...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28419741/optimal-treatment-strategy-for-acute-cholecystitis-based-on-predictive-factors-japan-taiwan-multicenter-cohort-study
#20
Itaru Endo, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Fumihiko Miura, Masamichi Yokoe, Takao Itoi, Harumi Gomi, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: Although early laparoscopic cholecystectomy is widely performed for acute cholecystitis, the optimal timing of a cholecystectomy in clinically ill patients remains controversial. This study aims to determine the best practice for the patients presenting with acute cholecystitis focused on disease severity and co-morbidities. PATIENTS AND METHODS: An international multicentric retrospective observational study was conducted over a 2-year period. Patients were divided into four groups, Group A: primary cholecystectomy, Group B: cholecystectomy after gallbladder drainage, Group C: gallbladder drainage alone, and Group D: medical treatment alone...
April 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
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