Niizato K.,Tokyo Metropolitan Matsuzawa Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2013
The function of each organ including the brain tends to decline with aging. This influences on the appearance of psychotic symptoms in the elderly. A manic state in the elderly is often atypical and different from that in younger and middle aged patients. Manic pseudodementia is an important symptom, which means that elderly manic patients easily show dementia-like behavior because of their Tatendrang(pressured action) or hyperkinesis, so they are misdiagnosed as having dementia. On medication, as the response to drugs is different to that in younger patients, side effects easily appear in the elderly. However, we have very few clinical-pharmacological data on the use of major tranquilizers including anti-manic drugs for elderly patients.
Okazaki Y.,Tokyo Metropolitan Matsuzawa Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2013
Recent development of understanding and psychiatric care on schizophrenia during past 30 years was reviewed. Slight brain volume reduction during early several years of the disease and association of psychotic symptoms with excess dopamine release in striatum were confirmed. A discovery of duration of untreated psychosis (DUP) has encouraged early intervention, hope for recovery from schizophrenia and liberation from old Kraepelin concept.
Harima H.,Tokyo Metropolitan Matsuzawa Hospital
Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica | Year: 2011
The term "acute psychosis" is commonly used as a provisional diagnosis in psychiatric acute settings, especially in emergency, when there is not sufficient information available to give a specific categorical diagnosis. The provisional diagnosis "acute psychosis" involves psychotic conditions with acute onset, psychotic conditions with unknown course and acute behavioural disorders with unknown subjective experiences. Because this provisional diagnosis is not a proper category, dimensional assessment of psychopathology including delusions, hallucinations, disorganization, mood/affect, catatonia and disorder of consciousness is required to start specific treatment. As "acute psychosis" is nosologically ill defined in the dichotomy of schizophrenia and mood disorder, traditional types such as bouffée délirante, cycloid psychoses and reactive psychosis are useful in practice as frames of reference. Because the provisional diagnosis of "acute psychosis" involves non-psychotic disorders such as adjustment disorders and personality disorders, the perspective of genetic understanding is helpful in making a non-dimensional differential diagnosis.
A cluster of central line-associated bloodstream infections due to rapidly growing nontuberculous mycobacteria in patients with hematologic disorders at a Japanese tertiary care center: An outbreak investigation and review of the literature
Tagashira Y.,Tokyo Metropolitan Tama General Medical Center |
Kozai Y.,Tokyo Metropolitan Tama General Medical Center |
Yamasa H.,Tokyo Metropolitan Tama General Medical Center |
Sakurada M.,Tokyo Metropolitan Tama General Medical Center |
And 2 more authors.
Infection Control and Hospital Epidemiology | Year: 2015
Background. Rapidly growing nontuberculous mycobacteria (RGM) are considered rare pathogens, causing central line–associated bloodstream infection. We identified an outbreak of central line–associated bloodstream infection due to RGM at a hematology-oncology ward during a 5-month period. design. Outbreak investigation and literature review. setting. A Japanese tertiary care center. patients. Adults who were hospitalized at the hematology-oncology ward from October 15, 2011, through February 17, 2012. results. A total of 5 patients with a bloodstream infection due to RGM (4 cases of Mycobacterium mucogenicum and 1 case of Mycobacterium canariasense infection) were identified; of these, 3 patients had acute myeloid leukemia, 1 had acute lymphocytic leukemia, and 1 had aplastic anemia. Four of the 5 patients received cord blood transplantation prior to developing the bloodstream infection. All central venous catheters in patients with a bloodstream infection were removed. These patients promptly defervesced after catheter removal and their care was successfully managed without antimicrobial therapy. Surveillance cultures fromthe environment and water detected M. mucogenicum and M. canariasense in the water supply of the hematology-oncology ward. The isolates from the bloodstream infection and water sources were identical on the basis of 16S-rRNA gene sequencing. conclusions. The source of RGM in the outbreak of bloodstream infections likely was the ward tap water supply. Awareness of catheterrelated bloodstream infections due to nontuberculous mycobacteria should be emphasized, especially where immunocompromised patients are at risk. Also, using antimicrobials after catheter removal to treat central line–associated bloodstream infection due to RGM may not be necessary. © 2015 by The Society for Healthcare Epidemiology of America. All rights reserved.
Aoki A.,Tokyo Metropolitan Matsuzawa Hospital
Translational psychiatry | Year: 2012
On 11 March 2011, the eastern part of Japan was struck by a magnitude 9.0 quake. About 20 000 people were killed or were missing, and a nuclear crisis followed. In Tokyo, people were indirectly exposed to the earthquake and nuclear crisis by TV broadcast. The aim of our study was to evaluate the potential effect of the series of catastrophes on psychiatric emergency hospitalizations in Tokyo. Clinical records of patients who were mandatorily admitted to Tokyo Metropolitan Matsuzawa Hospital by law because of urgent risk to self or others were reviewed. Records regarding the 2 years of investigation, which include the 6 months after the earthquake, were reviewed. The six months after the earthquake were compared with the eighteen months before the earthquake in clinical and demographic data using independent t-tests or χ(2) tests. During the 6 months before and after the earthquake, 97 and 127 people were mandatorily admitted. χ(2) Tests demonstrated a significant increase in the number of patients after the earthquake (P = 0.045), attributable to the significant increase in the number of patients with schizophrenia after the earthquake (P = 0.011, 32 vs 56), whereas there were no significant differences in the number of patients with other diagnoses between those two periods. Independent t-tests revealed that patients admitted after the earthquake had marginally significantly shorter periods of education compared with those admitted before the earthquake (13.78 vs 12.82 years, P = 0.084). This work suggests that patients with schizophrenia were more sensitive to indirect exposure to the earthquake and that a shorter period of education was a potential risk factor.