Kobe City Hospital Organization Kobe City Medical Center West Hospital

Kōbe-shi, Japan

Kobe City Hospital Organization Kobe City Medical Center West Hospital

Kōbe-shi, Japan

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Tane K.,Hyogo Cancer Center | Egawa C.,Kansai Rosai Hospital | Takao S.,Hyogo Cancer Center | Yamagami K.,Shinko Hospital | And 26 more authors.
Breast Cancer | Year: 2016

Background: Adverse events related to endocrine therapies have a major impact not only on patients’ quality of life but also on treatment discontinuation. Although vasomotor symptoms induced by aromatase inhibitors are frequently recognized, risk factors, especially for Japanese women, are not well reported. To identify risk factors for vasomotor symptoms of Japanese breast cancer patients treated with adjuvant anastrozole, we conducted a prospective cohort study based on patient-reported outcomes (PROs). Patients and methods: For this prospective cohort study (SAVS-JP, UMIN000002455), 391 postmenopausal Japanese estrogen receptor-positive breast cancer patients who were treated with adjuvant anastrozole were recruited from 28 centers. The PRO assessment was obtained from a self-reported questionnaire at baseline, 3, 6, 9 and 12 months between August 2009 and April 2012. Vasomotor symptoms, comprising hot flashes, night sweats, and cold sweats, were categorized into four grades (none, Grade 1: mild, Grade 2: moderate, Grade 3: severe). Pre-existing symptoms were only included if they had become worse than at baseline. Results: Hot flashes, night sweats, and cold sweats at baseline were reported by 20.5, 15.1, and 8.2 % of the patients, respectively, and new appearance or worsening of symptoms in comparison with baseline by 38.4, 29.3, and 28.7 %, respectively. About 80 % of newly occurring symptoms were Grade 1, and less than 5 % were Grade 3. Vasomotor symptoms were reported by 201 out of 362 patients (55.5 %) during the first year and the mean time to onset was 5.6 months. Patients with vasomotor symptoms were significantly younger (mean 62.8 years, range 38–86 vs 64.7 years, range 37–84; p = 0.02), had higher body mass index (BMI) (23.4 kg/m2, range 15.8–39.9 vs 22.4 kg/m2, range 15.8–34.9; p = 0.01), had vasomotor symptoms sooner after menopause (12.4 years, range 0–51 vs 15.1 years, range 1–37; p = 0.002), and had more menopausal disorders during menopause (63.3 vs 36.7 %; p = 0.002). Multivariate analysis showed that BMI [odds ratio (OR) 1.09 per unit of increase, 95 % confidence interval (CI) 1.02–1.16; p = 0.009] and experiencing menopausal disorders (OR 2.11, 95 % CI 1.35–3.30; p = 0.001) were significantly associated with vasomotor symptoms. Conclusion: High BMI and experiencing menopausal disorders at menopause were found to be significantly associated with the occurrence of vasomotor symptoms. These findings are expected to prove useful for the management of postmenopausal Japanese women treated with aromatase inhibitors. © 2016 The Japanese Breast Cancer Society


PubMed | Rokko Island Hospital, Kinki Central Hospital, Kitatsuji Clinic, Kohnan Hospital and 25 more.
Type: | Journal: Breast cancer (Tokyo, Japan) | Year: 2016

Adverse events related to endocrine therapies have a major impact not only on patients quality of life but also on treatment discontinuation. Although vasomotor symptoms induced by aromatase inhibitors are frequently recognized, risk factors, especially for Japanese women, are not well reported. To identify risk factors for vasomotor symptoms of Japanese breast cancer patients treated with adjuvant anastrozole, we conducted a prospective cohort study based on patient-reported outcomes (PROs).For this prospective cohort study (SAVS-JP, UMIN000002455), 391 postmenopausal Japanese estrogen receptor-positive breast cancer patients who were treated with adjuvant anastrozole were recruited from 28 centers. The PRO assessment was obtained from a self-reported questionnaire at baseline, 3, 6, 9 and 12months between August 2009 and April 2012. Vasomotor symptoms, comprising hot flashes, night sweats, and cold sweats, were categorized into four grades (none, Grade 1: mild, Grade 2: moderate, Grade 3: severe). Pre-existing symptoms were only included if they had become worse than at baseline.Hot flashes, night sweats, and cold sweats at baseline were reported by 20.5, 15.1, and 8.2% of the patients, respectively, and new appearance or worsening of symptoms in comparison with baseline by 38.4, 29.3, and 28.7%, respectively. About 80% of newly occurring symptoms were Grade 1, and less than 5% were Grade 3. Vasomotor symptoms were reported by 201 out of 362 patients (55.5%) during the first year and the mean time to onset was 5.6months. Patients with vasomotor symptoms were significantly younger (mean 62.8years, range 38-86 vs 64.7years, range 37-84; p=0.02), had higher body mass index (BMI) (23.4kg/mHigh BMI and experiencing menopausal disorders at menopause were found to be significantly associated with the occurrence of vasomotor symptoms. These findings are expected to prove useful for the management of postmenopausal Japanese women treated with aromatase inhibitors.


Furuta K.,Kobe City Hospital Organization Kobe City Medical Center West Hospital | Furuta K.,Foundation Medicine | Ito A.,Foundation Medicine | Ishida T.,Foundation Medicine | And 9 more authors.
Journal of Infection and Chemotherapy | Year: 2016

Background and objectives It can be difficult to treat respiratory tract infections caused by Mycobacterium abscessus (M. abscessus) as there is no established treatment strategy. Complications involving other nontuberculous mycobacterial infections such as Mycobacterium avium complex (MAC) are also commonly observed. Methods We investigated the clinical background and course of 18 cases of pulmonary M. abscessus infection treated over 8 years at Kurashiki Central Hospital. Radiological evaluation was performed using NICE scoring system, a method of semi-quantitative evaluation of imaging findings of pulmonary MAC infection. Results The mean age of the 18 patients (males, 6; females, 12) was 74.7 years. The median follow-up period was 1316 days (95% confidence interval; 720–1675 days), and 11 patients were concomitantly infected with pulmonary MAC. Among the patients that underwent antibacterial treatment for M. abscessus, there was one MAC-complication case and one non-MAC-complication case. All MAC-complication cases underwent antibacterial treatment including clarithromycin. Chest X-ray NICE scores for all cases were 8.50 ± 5.45 and 10.94 ± 6.03 at baseline and follow-up, respectively (p = 0.0063). For MAC-complication cases, scores were 8.36 ± 4.74 and 12.00 ± 6.02 at baseline and follow-up, respectively (p = 0.00818), and for non-MAC-complication cases, scores were 8.71 ± 6.82 and 9.29 ± 6.13 at baseline and follow-up, respectively (p = 0.356). MAC-complication cases were significantly further exacerbated than non-MAC-complication cases (p = 0.027). Conclusions Some cases of pulmonary M. abscessus infection progressed well without undergoing antibacterial treatment. In particular, results suggested that the clinical course of MAC-complication and non-MAC-complication cases differs. © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases


Matsumura T.,Kobe University | Mitani Y.,Kobe University | Mitani Y.,Sapporo Nishimaruyama Hospital | Oki Y.,Kobe University | And 7 more authors.
Heart and Lung: Journal of Acute and Critical Care | Year: 2015

Objectives: The Geriatric Nutritional Risk Index (GNRI) is a new prognostic indicator for nutritional status-related complications and mortality among the elderly. Here we aimed to compare 6-min walk distance (6MWD) between high and low GNRI groups for patients with COPD. Methods: We enrolled 63 elderly men with COPD. These subjects were divided into two groups based on their GNRI scores: high GNRI group (≥92 points; n = 44) and low GNRI group (n = 19); we compared 6MWD between these groups. Results: The subjects' characteristics between the high and the low GNRI groups were similar, except for BMI and serum albumin levels. 6MWD were significantly lower in the low GNRI group (279.5 ± 112.3 m versus 211.1 ± 125.3 m; p = 0.03). Conclusions: The GNRI has a more close relation with exercise tolerance and may be a useful nutritional assessment scale for elderly patients with COPD. © 2015 Elsevier Inc.

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