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Takei H.,Gunma University | Mitsui T.,Gunma University | Sato N.,Gunmaken Saiseikai Maebashi Hospital | Saito A.,Fujioka General Hospital | And 9 more authors.
Kitakanto Medical Journal | Year: 2014

Oral administration of multikinase inhibitor dasatinib showed significantly higher and faster rates of CCyR and MMR than imatinib in patients with newly diagnosed chronic myeloid leukemina (CML) -chronic phase (CP). The reactivation of hepatitis B virus (HBV) is a well-known complication for HBV carrier treated with cytotoxic or immunosuppressive agent. Although dasatinib may act as an immunosuppressive agent, it is unclear whether dasatinib induces the reactivation of HBV. Here, we report the combination therapy with dasatinib and entecavir in newly diagnosed CML-CP patient with HBV carrier. A 63-year-old man with HBV carrier newly diagnosed as CML-CP. HBV DNA levels in serum showed 2.4 log copies/ml. Before administration of dasatinib, the patient received 0.5mg of entecavir daily. Six days later, HBV DNA levels decreased less than 2.1 log copies/ml. Then, lOOmg of dasatinib was administrated in combination with entecavir daily. Partial cytogenic response was achieved at day 90. At one year, major molecular response was achieved. Neither adversed events (AEs) of liver function nor evidence of reactivation of HBV was observed. Combination with entecavir and dasatinib is safe and effective therapy for newly diagnosed CML-CP with HBV carrier. Accumulation of such cases is necessary to optimize the treatment approach.

Matsumoto M.,Gunmaken Saiseikai Maebashi Hospital
Sangyō eiseigaku zasshi = Journal of occupational health | Year: 2014

To objectively evaluate sleep quality of shift-working nurses, we used an Actiwatch 2, a watch-like actigraphy device designed to measure sleep and wakefulness based on the amount of movement. Subjective sleep quality was also assessed using the St. Mary's Hospital Sleep Questionnaire. Nineteen shift-working nurses wore the Actiwatch 2 for 5 days. The monitoring began with 2 days of the morning shift, which were followed by a 16-hour night shift and a rest day. Sleep recordings were obtained four times: night sleep after the second morning shift ("sleep 1"), napping on the night shift ("nap 1"), daytime napping after the night shift ("nap 2") and night sleep after the night shift ("sleep 2"). Actiwatch 2 sleep measures include sleep onset latency, snooze time, sleep efficiency, and percent sleep. In addition, the perceived quality of sleep was obtained using five questions of the St. Mary's Hospital Sleep Questionnaire. Objective and subjective sleep quality were compared between different sleep/nap times: sleep 1 vs. sleep 2, and nap 1 vs. nap 2. Percent sleep of sleep 2 was higher than that of sleep 1. In almost all responses to the St. Mary's Hospital Sleep Questionnaire, the perceived quality of sleep on sleep 2 was better than those of sleep 1, and that of nap 2 was better than nap 1. A significant negative correlation was found between the perceived sleep quality of nap 2 and the characteristics of participants (age, number of children, and length of career). There were positive correlations between the perceived sleep quality of sleep and percent sleep, and between the perceived sleep quality of nap and sleep efficiency. Moreover, the perceived sleep quality of nap 2 tended to decrease in participants whose bedtime deviated from the mean value on morning shift days and the rest day. We found that perceived sleep quality is related to percent sleep, and that the perceived sleep quality of nap is related to sleep efficiency. The results suggest that improving the sleep quality of daytime napping after the night shift is necessary for nurses with children, and that keeping a regular bedtime is necessary to improve the sleep quality of napping on the night shift.

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