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Treatment of Asthma in the Elderly: Questionnaire Survey in Japan

International Journal of Clinical Medicine 2017年第4期8卷 236-247页

作者： Sahoko Chiba Kimitake Tsuchiya Tomoyuki Ogata Reina Imase Tamon Yagi Yuka Mishima Torahiko Jinta Kazuhito Saito Reiko Taki Susumu Isogai Yasuto Jinn Tsutomu Kawasaki Ichiro Natsume Yoshihiro Miyashita Jun Takagiwa Nobuo Ishiwata Tomoshige Chiaki masato kishi Yoshikazu Tsukada Motohisa Yamasaki Naohiko Inase Department of Respiratory Medicine Tokyo Medical and Dental University Tokyo Japan JA Toride Medical Center Ibaraki Japan St. Luke’s International Hospital Tokyo Japan Tsuchiura Kyoudou General Hospital Ibaraki Japan Japanese Red Cross Musashino Hospital Tokyo Japan Ome Municipal General Hospital Tokyo Japan Hiratsuka Kyosai Hospital Kanagawa Japan Yokohama City Minato Red Cross Hospital Kanagawa Japan Yokosuka Kyosai Hospital Kanagawa Japan Yamanashi Prefectural Central Hospital Yamanashi Japan Tokyo Kyosai Hospital Tokyo Japan Kudanzaka Hospital Tokyo Japan Hokushin General Hospital Nagano Japan Mishima General Hospital Shizuoka Japan Soka Municipal Hospital Saitama Japan Nitobe Memorial Nakano General Hospital Tokyo Japan

Introduction: The prevalence of asthma in the elderly has been increasing due to the aging of the global population. Appropriate treatment for asthma in the elderly is now a major issue, as the disease is often fatal and incurs high medical costs in the elderly population. There have been few recent reports on asthma treatment for the elderly in the real-world clinical settings. Objectives: This study was performed to assess how respiratory physicians manage asthma in elderly patients in clinical settings in Japan. Methods: Respiratory physicians in 16 Japanese hospitals responded to a questionnaire survey on asthma and COPD treatment between December 2014 and February 2015. The analysis was performed using data collected from medical records on 2041 asthma patients. Results: The mean patient age was 61.2 years, and 36.6% of the patients were men. In the breakdown by age, 1018 (49.9%) of the patients were elderly (≥ 65 years). Compared to the non-elderly, the elderly patients had a significantly lower BMI, greater smoking history in pack-years, and poorer pulmonary function. There were no significant differences between the elderly and non-elderly in the prescription rates of common medications such as inhaled corticosteroids, long-acting beta-agonists (LABA) administered via inhaler or transdermal patch, long-acting muscarinic antagonists, or leukotriene receptor antagonists. In contrast, mucoactive drugs (18.7% vs. 12.3%, P P P = 0.02). Conclusions: According to this survey, the prescription rates of mucoactive drugs, macrolides, and transdermal LABA were significantly higher in the elderly than in the non-elderly.

关键词： Asthma Elderly Transdermal LABA Aging

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Solitary mediastinal lymph node recurrence after curative resection of colon cancer

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World Journal of Gastrointestinal Surgery 2014年第8期6卷 164-168页

作者： Yasuhiro Matsuda Masahiko Yano Norikatsu Miyoshi Shingo Noura Masayuki Ohue Keijiro Sugimura Masaaki Motoori Kentaro kishi Yoshiyuki Fujiwara Kunihito Gotoh Shigeru Marubashi Hirofumi Akita Hidenori Takahashi masato Sakon Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Disease

We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.

关键词： Solitary mediastinal lymph node recurrence Colon cance

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