Introduction: The prevalence of asthma in the elderly has been increasing due to the aging of the global population. Appropriate treatment for asthma in the elderly is now a major issue, as the disease is often fatal ...Introduction: The prevalence of asthma in the elderly has been increasing due to the aging of the global population. Appropriate treatment for asthma in the elderly is now a major issue, as the disease is often fatal and incurs high medical costs in the elderly population. There have been few recent reports on asthma treatment for the elderly in the real-world clinical settings. Objectives: This study was performed to assess how respiratory physicians manage asthma in elderly patients in clinical settings in Japan. Methods: Respiratory physicians in 16 Japanese hospitals responded to a questionnaire survey on asthma and COPD treatment between December 2014 and February 2015. The analysis was performed using data collected from medical records on 2041 asthma patients. Results: The mean patient age was 61.2 years, and 36.6% of the patients were men. In the breakdown by age, 1018 (49.9%) of the patients were elderly (≥ 65 years). Compared to the non-elderly, the elderly patients had a significantly lower BMI, greater smoking history in pack-years, and poorer pulmonary function. There were no significant differences between the elderly and non-elderly in the prescription rates of common medications such as inhaled corticosteroids, long-acting beta-agonists (LABA) administered via inhaler or transdermal patch, long-acting muscarinic antagonists, or leukotriene receptor antagonists. In contrast, mucoactive drugs (18.7% vs. 12.3%, P P P = 0.02). Conclusions: According to this survey, the prescription rates of mucoactive drugs, macrolides, and transdermal LABA were significantly higher in the elderly than in the non-elderly.展开更多
The radiation dosimetry in medical practice requires special phantom to simulate the organs and tissues of a human body. To achieve the same elemental composition as that of the human lung by weight percent, we constr...The radiation dosimetry in medical practice requires special phantom to simulate the organs and tissues of a human body. To achieve the same elemental composition as that of the human lung by weight percent, we constructed lung equivalent phantom (LEP) using cork with absorbed water in order for it to uniformly absorb the water. Then, we presented the physical properties and dosimetric characteristics of other commercial phantoms and the LEP. We found that the physical properties and dosimetric characteristics of the LEP were approximately the same as those of human lung tissue. LEP constitutes a new dosimetry tool because it can provide the dose distributions and point doses similar to those for the body with respiratory motion of lung.展开更多
Introduction: Recently, the diagnosis of occult frac- tures has been facilitated due to increased availability and utilization of MRI. Diagnosing a fracture of the ischiopubic rami from a proximal femoral fracture, in...Introduction: Recently, the diagnosis of occult frac- tures has been facilitated due to increased availability and utilization of MRI. Diagnosing a fracture of the ischiopubic rami from a proximal femoral fracture, in particular, is difficult using physical exam alone and can be facilitated by having access to an MRI. Here we report both physical exam findings and MRI findings that help in differentiating occult fractures of the iliopubic rami. Materials and Methods: From April 2010 to December 2012, we identified 30 pa- tients (5 male and 25 female;aged 43 - 93 years old). We recorded if a traumatic episode occurred, ambu- latory status at the initial visit (bed ridden, standing up with an aid, walking with an aid). We also re- corded if imaging was used in determining the final diagnosis (radiographs, MRI or CT). Results: Twenty- one patients had a fracture as a result of a traumatic episode. In the remaining 9 cases, no trauma oc- curred and therefore the fractures were insufficiency fractures. Ten patients were bed ridden at the initial visit, eight patients were able to stand only with a walking aid, and the remaining twelve patients were able to walk with an aid. Occasional radiographs were used to confirm the presence of a fracture in 4 cases, MRI in 11 cases, and CT scan in 15 cases. Dis- cussion and Conclusions: Occult fractures of the is- chiopubic rami can occur without trauma and it can be difficult to differentiate these fractures from occult proximal femoral fractures. In these cases, MRI is useful to definitively obtain a diagnosis. In cases of pacemaker, bullet implantation or artificial hip joints, CT or occasional radiographs are also useful to diag- nose occult fractures of the ischiopubic rami.展开更多
文摘Introduction: The prevalence of asthma in the elderly has been increasing due to the aging of the global population. Appropriate treatment for asthma in the elderly is now a major issue, as the disease is often fatal and incurs high medical costs in the elderly population. There have been few recent reports on asthma treatment for the elderly in the real-world clinical settings. Objectives: This study was performed to assess how respiratory physicians manage asthma in elderly patients in clinical settings in Japan. Methods: Respiratory physicians in 16 Japanese hospitals responded to a questionnaire survey on asthma and COPD treatment between December 2014 and February 2015. The analysis was performed using data collected from medical records on 2041 asthma patients. Results: The mean patient age was 61.2 years, and 36.6% of the patients were men. In the breakdown by age, 1018 (49.9%) of the patients were elderly (≥ 65 years). Compared to the non-elderly, the elderly patients had a significantly lower BMI, greater smoking history in pack-years, and poorer pulmonary function. There were no significant differences between the elderly and non-elderly in the prescription rates of common medications such as inhaled corticosteroids, long-acting beta-agonists (LABA) administered via inhaler or transdermal patch, long-acting muscarinic antagonists, or leukotriene receptor antagonists. In contrast, mucoactive drugs (18.7% vs. 12.3%, P P P = 0.02). Conclusions: According to this survey, the prescription rates of mucoactive drugs, macrolides, and transdermal LABA were significantly higher in the elderly than in the non-elderly.
文摘The radiation dosimetry in medical practice requires special phantom to simulate the organs and tissues of a human body. To achieve the same elemental composition as that of the human lung by weight percent, we constructed lung equivalent phantom (LEP) using cork with absorbed water in order for it to uniformly absorb the water. Then, we presented the physical properties and dosimetric characteristics of other commercial phantoms and the LEP. We found that the physical properties and dosimetric characteristics of the LEP were approximately the same as those of human lung tissue. LEP constitutes a new dosimetry tool because it can provide the dose distributions and point doses similar to those for the body with respiratory motion of lung.
文摘Introduction: Recently, the diagnosis of occult frac- tures has been facilitated due to increased availability and utilization of MRI. Diagnosing a fracture of the ischiopubic rami from a proximal femoral fracture, in particular, is difficult using physical exam alone and can be facilitated by having access to an MRI. Here we report both physical exam findings and MRI findings that help in differentiating occult fractures of the iliopubic rami. Materials and Methods: From April 2010 to December 2012, we identified 30 pa- tients (5 male and 25 female;aged 43 - 93 years old). We recorded if a traumatic episode occurred, ambu- latory status at the initial visit (bed ridden, standing up with an aid, walking with an aid). We also re- corded if imaging was used in determining the final diagnosis (radiographs, MRI or CT). Results: Twenty- one patients had a fracture as a result of a traumatic episode. In the remaining 9 cases, no trauma oc- curred and therefore the fractures were insufficiency fractures. Ten patients were bed ridden at the initial visit, eight patients were able to stand only with a walking aid, and the remaining twelve patients were able to walk with an aid. Occasional radiographs were used to confirm the presence of a fracture in 4 cases, MRI in 11 cases, and CT scan in 15 cases. Dis- cussion and Conclusions: Occult fractures of the is- chiopubic rami can occur without trauma and it can be difficult to differentiate these fractures from occult proximal femoral fractures. In these cases, MRI is useful to definitively obtain a diagnosis. In cases of pacemaker, bullet implantation or artificial hip joints, CT or occasional radiographs are also useful to diag- nose occult fractures of the ischiopubic rami.
