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Catechol-O-methyltransferase (COMT) inhibitors are used to alleviate motor fluctuations, such as wearing-off, in people with Parkinson’s disease (PwPD). Opicapone, a COMT inhibitor has long-lasting efficacy when administered once daily, but there is limited real-world clinical data in Japanese participants. This study aimed to evaluate the one-year continuation rate of opicapone in Japanese PwPD in real-world clinical practice and to identify factors influencing this continuation rate. This retrospective study analyzed data from 58 Japanese PwPD treated with opicapone at the Department of Neurology, Fukuoka University Hospital. We compared patients who continued opicapone for one year with those who discontinued it and examined factors influencing the continuation rate. Among the 58 PwPD, 26 (44.8%) continued opicapone for one year. Binomial logistic regression analysis identified male sex (odds ratio: 0.223, 95 % confidence interval: 0.056-0.878) and switching from entacapone (odds ratio: 0.215, 95 % confidence interval: 0.056-0.825) as significant factors influencing the one-year continuation rate. Switching to opicapone in patients with suboptimal responses to entacapone may enhance the continuation rate. •One-year continuation rate of opicapone in Japanese patients with Parkinson's disease was 44.8 %.•Patients of male sex and those who switched from entacapone had higher continuation rates of opicapone.•Poor efficacy was the most common reason for opicapone discontinuation.•Adverse events, including dyskinesia and hallucinations, occurred mostly within the first three months of starting opicapone.•Opicapone may improve motor symptoms in patients inadequately controlled with entacapone.

Drug-induced allergy (DIA), an unexpectedly triggered side effect of drugs used for therapeutic purposes, is a serious clinical issue that needs to be resolved because it interrupts the treatment of the primary disease. Since conventional allergy testing is insufficient to accurately predict the occurrence of DIA or to determine the drugs causing it, the development of diagnostic and predictive tools for allergic reactions is important. We demonstrated a novel method, termed high-sensitive allergy test (HiSAT), for the rapid diagnosis of allergy (within 1 hr; with true-positive diagnosis rates of 89% and 9% for patients with and without allergy-like symptoms, respectively). HiSAT analyzes the cell kinetics as an index against chemotactic factors in a patient’s serum, as different from the diagnosis using conventional methods. Once allergy has occurred, HiSAT can be used to determine the causative medicine using culture supernatants incubated with the subject’s lymphocytes and the test allergen. This test is more efficient (60%) than the lymphocyte transformation test (20%). Furthermore, in HiSAT, cell mobility significantly increases in a dose-dependent manner against supernatant incubated with lymphocytes from a subject with pollinosis collected at a time when the subject is without allergic symptoms and the antigen. The result demonstraed that HiSAT might be a promising method to rapidly diagnose DIA or to determine with high accuracy the antigen causing allergy.

Serum alanine aminotransferase (ALT), which is an indicator of liver dysfunction, may increase during treatment in patients in the acute phase of stroke. However, the cause of the ALT elevation is unclear, as multiple medications are often being used. We investigated the relationship between medications used in acute ischemic stroke, including cerebral infarction and transient ischemic attack, and ALT elevation. The subjects were 230 patients who had been diagnosed with cerebral infarction or TIA and treated at the Stroke Care Unit of Fukuoka University Hospital. We investigated ALT abnormalities that occurred from the start of the treatment over the subsequent 14 days. We also followed patients for an additional seven days to confirm the peak ALT levels. A binomial logistic regression analysis was performed to evaluate the association between medications used during the period and ALT elevation. The incidence of ALT abnormality was 23.9% (55/230). ALT elevation was mostly mild and peaked within 21 days of treatment initiation in 93.2% of the patients, excluding indeterminate patients. A binary logistic regression analysis showed that unfractionated heparin (odds ratio [OR] 2.759, 95% confidence interval [CI] 1.328–5.729, p = 0.007) was extracted as a cause of ALT elevation. In a receiver operating characteristic (ROC) analysis for the administration period of unfractionated heparin, the cut-off value (area under the ROC curve) for ALT elevation was 6 days (0.575). Significant factors contributing to ALT elevation caused by unfractionated heparin included an unfractionated heparin administration period of ≥ 6 days (OR 2.951, 95% CI 1.244–7.000, p = 0.014) and edaravone combination (OR 2.594, 95% CI 1.159–5.808, p = 0.021). In the acute phase of stroke, we believe that unfractionated heparin discontinuation is not necessary when hepatotoxicity of unfractionated heparin is suspected. However, physicians should be aware of the risk of liver toxicity when unfractionated heparin is administered for more than six days or when edaravone is used in combination. •The link between medications in the acute ischemic stroke patients and ALT abnormalities was assessed.•The clinical charts of 230 patients in the acute phase of cerebral infarction or transient ischemic attack were reviewed.•A binary logistic regression analysis showed that unfractionated heparin was extracted as a cause of ALT elevation.•Changes in ALT levels should be monitored when heparin is used for more than six days or when edaravone is used in combination.

•A group taking rotigotine for the first time had low discontinuation rate (3.8%).•The discontinuation rate due to poor efficacy was low in the de novo group (3.8%).•Overnight switch group had high discontinuation rate (21.2%).•The discontinuation rate due to poor efficacy was high in the overnight switch group (21.2%) Ways of introducing a rotigotine patch to Parkinson disease (PD) patients include initial induction for dopamine agonist (DA)-free patients and overnight switch (OS), cross-titration (CT), and add-on (AO) for patients already taking oral DAs. We investigated whether or not the introductions method affects the continuation rate of rotigotine patch. The subjects were 188 PD patients who started using a rotigotine patch at the Department of Neurology, Fukuoka University Hospital. The rate of successful continuation of rotigotine patch for one year after initiation and the reasons for discontinuation were investigated; for the patients who discontinued due to poor efficacy, the DA dose before and after the start of rotigotine patch treatment was determined. The 1-year continuation rates were 38.5 % (20/52) in the OS group, 61.5 % (8/13) in the CT group, 35.3 % (6/17) in the AO group, and 50.9 % (54/106) in the de novo group. The most common reason for discontinuation in all groups was skin reactions. Compared with the de novo group, only the OS group had a significantly higher discontinuation rate due to poor efficacy (3.8 % vs. 21.2 %, P <  0.001). However, in the OS group, the continuation rate in the subjects with an increased total DA dose, after rotigotine was introduced, was significantly higher than that in the subjects with a decreased total DA dose (p = 0.031). The use of a rotigotine patch with an equivalent dose should be considered when switching from oral DAs, and appropriate care should be administered for any skin reactions. The present findings suggested that not the introduction method but the use of an equivalent dose between DA formulations might affect the continuation rate of rotigotine patch.

We explore an innovative approach to sleep stage analysis by incorporating complexity features into sleep scoring methods for mice. Traditional sleep scoring relies on the power spectral features of electroencephalogram (EEG) and the electromyogram (EMG) amplitude. We introduced a novel methodology for sleep stage classification based on two types of complexity analysis, namely multiscale entropy and detrended fluctuation analysis. Our analysis revealed significant variances in these complexities, not only within the specific theta and delta bands but across a wide frequency spectrum. Based on these findings, we developed a sleep stage scoring model, termed Sleep Analyzer Complex (SAC), a convolutional neural network model that integrates these complexity features with conventional EEG spectrum and EMG amplitude analysis. This integrated model significantly enhances the accuracy of sleep stage identification, achieving an accuracy of 97.4–98.1% for novel wild-type mice, on par with the agreement level among human scorers (97.3–97.8%). The efficacy of SAC was validated through tests conducted on wild-type mice, and it demonstrated remarkable success in identifying sleep architecture abnormalities in narcoleptic mice as well. This approach not only facilitates automated scoring of sleep/wakefulness states but also holds the potential to uncover detailed physiological insights, thereby advancing EEG-based sleep research.

To investigate the relationship between viral load and secondary transmission in novel coronavirus disease 2019 (COVID-19). Epidemiological and clinical data were obtained from immunocompetent laboratory-confirmed patients with COVID-19 who were admitted to and/or from whom viral loads were measured at Toyama University Hospital. Using a case-control approach, index patients who transmitted the disease to at least one other patient were analysed as \"cases\" (index patients) compared with patients who were not the cause of secondary transmission (non-index patients, analysed as \"controls\"). The viral load time courses were assessed between the index and non-index symptomatic patients using non-linear regression employing a standard one-phase decay model. In total, 28 patients were included in the analysis. Median viral load at the initial sample collection was significantly higher in symptomatic than in asymptomatic patients and in adults than in children. Among symptomatic patients (n = 18), non-linear regression models showed that the estimated viral load at onset was higher in the index than in the non-index patients (median [95% confidence interval]: 6.6 [5.2-8.2] vs. 3.1 [1.5-4.8] log copies/μL, respectively). In adult (symptomatic and asymptomatic) patients (n = 21), median viral load at the initial sample collection was significantly higher in the index than in the non-index patients (p = 0.015, 3.3 vs. 1.8 log copies/μL, respectively). High nasopharyngeal viral loads around onset may contribute to secondary transmission of COVID-19. Viral load may help provide a better understanding of why transmission is observed in some instances, but not in others, especially among household contacts.