Title Alternative Molecular target therapies in rheumatic diseases
FullText URL 126_227.pdf
Author Wakabayashi, Hiroshi|
Keywords リウマチ性疾患 自己免疫疾患 生物学的製剤 分子標的薬
Publication Title 岡山医学会雑誌
Published Date 2014-12-01
Volume volume126
Issue issue3
Start Page 227
End Page 230
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.227
NAID 130004903237
Title Alternative Hospital and clinic cooperation for the treatment of rheumatoid arthritis in Okayama Prefecture, Japan
FullText URL 126_209.pdf
Author Sada, Ken-ei| Nishida, Keiichiro| Yamanaka, Takao| Misaki, Kenta| Wakabayashi, Hiroshi| Shinoda, Junko| Takagi, Toru| Yano, Ryusuke| Nakamura, Akihiko| Nanba, Yoshifumi| Morita, Yoshitaka| Koyama, Yoshinobu| Yamamoto, Keiji| Ezawa, Kazuhiko| Ota, Yusuke| Yoshihara, Yoshiki| Miyoshi, Shinya| Natsumeda, Masamitsu| Usui, Masaaki| Yoshinaga, Yasuhiko| Hayashi, Takashi| Yamamura, Masahiro| Hashizume, Hiroyuki|
Abstract Objective: To survey the current status and problems of cooperation between clinics and hospitals in Okayama Prefecture, Japan for the treatment of rheumatoid arthritis (RA).  Methods: We distributed a questionnaire to 300 of the 983 Okayama Prefecture clinics that had either an internal medicine or orthopedic surgery department, from December 2013 to February 2014. The questionnaire covered practice pattern for RA treatment in clinics, current status of the hospital and clinic cooperation, and acceptance of the biologic therapy.  Results: One hundred clinics responded to the questionnaire. Seventy percent of the clinics reported making referrals to rheumatologists before the initiation of RA treatment, and half of the other 30% of the clinics administered methotrexate as the first-line treatment for RA by their own decision. Sixty-six clinics cooperated with flagship hospitals, conducting medical and laboratory examinations, providing prescriptions, and treating common diseases of patients. These clinics expected the cooperating rheumatologists to follow-up patients every 3 to 6 months and to make the diagnosis, make decisions regarding RA treatment changes, and perform surgery. Seventy-one percent of the clinics responded that cooperation with a hospital is possible even for patients who are administered biologics. As reasons for no cooperation with the flagship hospitals, clinics noted the lack of information about rheumatologists in the area and recent trends in the management of RA.  Conclusion: The current study reported, for the first time, the actual conditions of management of RA in clinics, as well as future problems of hospital and clinic cooperation in Okayama Prefecture.
Keywords 病診連携(hospital and clinic cooperation) 関節リウマチ(rheumatoid arthritis) 生物学的製剤(biologics) メトトレキサート(methotrexate)
Publication Title 岡山医学会雑誌
Published Date 2014-12-01
Volume volume126
Issue issue3
Start Page 209
End Page 215
ISSN 0030-1558
language Japanese
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.209
NAID 130004903246
Author Wakabayashi, Hiroshi| Ito, Toshihiro| Fushimi, Soichiro| Nakashima, Yuki| Itakura, Jyunya| Liu, Qiuying| Win, Min Min| Sun, Cuiming| Chen, Cao| Sato, Miwa| Mino, Megumi| Ogino, Tetsuya| Makino, Hirofumi| Yoshimura, Akihiko| Matsukawa, Akihiro|
Published Date 2012-09
Publication Title Clinical Immunology
Volume volume144
Issue issue3
Content Type Journal Article
JaLCDOI 10.18926/AMO/47015
FullText URL 65_5_329.pdf
Author Matsumoto, Yoshinori| Sada, Ken-ei| Takano, Mariko| Toyota, Noriko| Yamanaka, Ryutaro| Sugiyama, Koichi| Wakabayashi, Hiroshi| Kawabata, Tomoko| Otsuka, Fumio| Makino, Hirofumi|
Abstract It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age≧65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine level≧2.0mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR=4.50, 95%CI=1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
Keywords infection rheumatic disease glucocorticoids interstitial pneumonia risk factors
Amo Type Original Article
Publication Title Acta Medica Okayama
Published Date 2011-10
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 329
End Page 334
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037270
Web of Science KeyUT 000296116400007
JaLCDOI 10.18926/AMO/32712
FullText URL fulltext.pdf
Author Yamamoto, Goki| Tanabe, Masatada| Wakabayashi, Hiroshi| Hashimoto, Gonosuke| Yamamoto, Michio|
Abstract

Effect of inorganic phosphate on ferrous ion- and ascorbate-induced lipid. peroxidations of isolated rat liver mitochondria was investigated. As a result it has been shown that phosphate accelerates the ferrous ion.induced lipid peroxidation; namely, phos. phate shortens the induction lag period of the lipid peroxidation reaction but the malondialdehyde after onset of its production is yielded at the same rate in various concentrations of phosphate. On the other hand, phosphate inhibits ascorbate.induced lipid peroxidation. There are stoichiometric interactions between the concentration of phos. phate and the induction period. Oxygen uptake by mitochondria was observed in the presence of both ferrous ion and phosphate at initial step of the reaction without being accompanied by malondialdehyde production, and afterwards there occurred malondialdehyde production with rapid rate of the oxygen uptake. Possible mechanisms and interactions among ferrous ion, ascorbate and phosphate were discussed.

Amo Type Article
Publication Title Acta Medica Okayama
Published Date 1974-10
Volume volume28
Issue issue5
Publisher Okayama University Medical School
Start Page 299
End Page 310
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language English
File Version publisher
Refereed True
PubMed ID 4281994
NAID 120002312249
Author Wakabayashi, Hiroshi|
Published Date 1976-04-30
Publication Title 岡山医学会雑誌
Volume volume88
Issue issue3-4
Content Type Journal Article