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Epidemiology,clinical characteristics,and management of chronic kidney disease in human immunodeficiency virusinfected patients

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World Journal of Nephrology 2015年第3期4卷 388-395页

作者： minoru ando Naoki Yanagisawa Division of Nephrology Department of MedicineTokyo Metropolitan Komagome Hospital Division of Infectious Diseases Department of MedicineTokyo Metropolitan Komagome Hospital

Antiretroviral therapy has markedly reduced acquired immune deficiency syndrome-related deaths and opportunistic infectious diseases. This has resulted in prolonged survival of individuals infected with the human immunodefciency virus （HIV）. However, this improvement in survival has been accompanied by an increase in the incidence of chronic kidney disease （CKD） and end-stage renal disease. CKD is now epidemic among HIV-infected populations in both Western and Eastern countries. Risk factors associated with CKD in HIV-infected populations include aging, hypertension, diabetes mellitus, co-infection with hepatitis C virus, a low CD4 cell count, and a high HIV viral load. Clinical experience has shown that HIV-infected individuals often have one or more concurrent risk factors for CKD. The cumulative effect of multiple risk factors on the development of CKD should be noted in this population. Glomerular disease directly related to HIV infection, so-called HIV-associated nephropathy, remains an important cause of CKD among a limited HIV population of African descent, but is less likely to be common among other urban HIV populations. The impact of exposure to nephrotoxic antiretroviral agents on the development of kidney disease is both an old and a new concern. In particular, the association of tenofovir with kidney tubular injury has been an area of great interest. The fndings regarding tenofovir’s adverse effect on long-term kidney function vary among studies. The early identifcation and treatment of CKD is recommended for reducing the burden of patients requiring dialysis in HIV-infected populations. Periodic monitoring of urinary concentrations of albumin, protein, and tubular injury markers such as low-molecular-weight proteins may be useful for the early diagnosis of patients at risk for incident CKD. This review focuses on recent epidemiology, clinical characteristics, and management of CKD in a contemporary HIV-infected population.

关键词： Antiretroviral therapy Tenofovir Human immunodeficiency virus-associated nephropathy Albuminuria Renal tubular biomarkers Cystatin C Diabetes mellitus Hypertension

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Enhanced Public Health Surveillance for the Sixth Worldwide Uchinanchu Festival Conducted by the Okinawa Prefectural Government, Japan

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Journal of Biosciences and Medicines 2017年第9期5卷 106-115页

作者： Munesada Yamakawa Miyuki Yamauchi minoru Nidaira Tomoyuki Azuma Tadashi Nakasone Fumie ando Takahiro Hayamizu Saki Kinjo Yuuki Nakamura Regional Public Health Division Department of Public Health and Medical Care Okinawa Prefectural Government Okinawa Japan Naha City Public Health Center Okinawa Japan Graduate School of Pharmacy Nihon University Chiba Japan

Objective: The Okinawa prefectural government conducted enhanced surveillance for the Sixth Worldwide Uchinanchu Festival, with participation of more than 5300 visitors from abroad, many of whom were Okinawan or of Okinawan descent, for early detection of Zika virus disease and other potential public health threat outbreaks. Method: Enhanced surveillance conducted from 12 October through 13 November involved four surveillance systems, (Nursery) School Absenteeism Surveillance system ((N)SASSy), Prescription Surveillance (PS), and Official Syndromic Surveillance (OSS), each of them operates routinely, in addition to case-based and sentinel surveillance under the Infectious Diseases Control Law as Official National Surveillance of Infectious Diseases (ONSID). This enhanced surveillance was conducted for analysis and evaluation, with intensive information sharing among concerned parties. Result: We performed the enhanced surveillance for 33 days from 12 October through 13 November. Information from enhanced surveillance was analyzed and evaluated, and eventually summarized as a daily report. There has been one rubella case at an elementary school in Okinawa City on 20 October and a measles case at an elementary school in Uruma City on 2 November. Those two cases were registered into (N)SASSy on a timely basis. The public health center investigated them quickly, and the measles case was denied later because symptoms did not satisfy with case definition. Discussion: We regard enhanced surveillance as useful to confirm events that might demand a public health response. Moreover, the related including public health centers or medical institutions confirmed the situation as valuable for the administrative structure. However, because almost all (nursery) schools or pharmacies are closed during successive holidays, outbreaks that occur on such days cannot be recognized on a timely basis. More sensitive surveillance for such days, with better preparations for ambulance transfe

关键词： Enhanced Surveillance Syndromic Surveillance Mass Gathering School Absenteeism Prescription

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Effects of Semi-Solid Enteral Formula on Aspiration Pneumonia and Diarrhea

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International Journal of Clinical Medicine 2020年第4期11卷 193-198页

作者： minoru Oishi Minako Yasuda Mao Chikamatsu Rena Akiyama Michio Yamamoto Keisuke Terakawa Yumi Suzuki Mizuki ando Mariko Shimada Tadashi Kumagai Akiko Nakayama Swallowing Team Koshinkai Izu Tobu Hospital Higashi-Izu Japan

Objective: The effects of semi-solid enteral formula were investigated in tube feeding patients with aspiration pneumonia and/or diarrhea caused by liquid enteral formula. Methods: In 25 cases of aspiration pneumonia and 10 cases of diarrhea (5 cases had both aspiration pneumonia and diarrhea) caused by liquid enteral formula, the rate of improvement by changing the liquid enteral formula to semi-solid enteral formula was studied. The semi-solid enteral formula (PG Soft®EJ) was infused via the nasogastric tube (16Fr) or percutaneous endoscopic gastrostomy (PEG) tube (20Fr). Results: The semi-solid enteral formula was effective in 72% of aspiration pneumonia cases and in 80% of diarrhea cases. Constipation was observed in one case but was controlled with magnesium oxide. Conclusion: In cases of aspiration pneumonia and/or diarrhea, changing liquid enteral formula to semi-solid enteral formula frequently shows improvement.

关键词： Semi-Solid Enteral Formula Tube Feeding Aspiration Pneumonia Diarrhea Liquid Formula Syndrome

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