JMA journal最新文献

{"title":"Determinants and Clinical Impact of Visit-to-visit Blood Pressure Variability in Patients with Heart Failure with Preserved Ejection Fraction.","authors":"Chinatsu Komiyama, Nobuyuki Kagiyama, Takuya Yuri, Akihiro Hayashida, Atsushi Hirohata, Kiyoshi Yoshida, Yuya Matsue, Tohru Minamino","doi":"10.31662/jmaj.2024-0256","DOIUrl":"10.31662/jmaj.2024-0256","url":null,"abstract":"<p><strong>Introduction: </strong>Blood pressure (BP) affects the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). However, the implications of its variability are poorly understood. This study aimed to explore the determinants and prognostic significance of visit-to-visit BP variability (V2V-BPV) in HFpEF.</p><p><strong>Methods: </strong>Consecutive patients with HFpEF at the Sakakibara Heart Institute of Okayama underwent routine BP measurements. V2V-BPV, calculated as the coefficient of variation of systolic BP over one year, was assessed. The primary endpoint comprised all-cause mortality and heart failure hospitalization.</p><p><strong>Results: </strong>Among 288 outpatients with HFpEF (average age 73 ± 10 years, 60.8% male), BP was measured 6.1 ± 1.7 times, with a median V2V-BPV of 7.3%. The high V2V-BPV group (≥7.3%) had marginally but significantly elevated B-type natriuretic peptide (BNP) levels and higher Meta-Analysis Global Group In Chronic Heart Failure risk scores (MAGGIC scores). V2V-BPV was independently associated with an increased risk of the primary endpoints (hazard ratio 1.08 per percentage point; p = 0.025), even after adjustments for systolic BP, BNP, MAGGIC score, and the number of BP measurements. A similar relationship was observed between all-cause mortality and V2V-BPV (adjusted hazard ratio 1.12, p = 0.049 with MAGGIC score). Hemoglobin level was an independent predictor of high V2V-BPV in multiple sensitivity analyses.</p><p><strong>Conclusions: </strong>In patients with HFpEF, V2V-BPV was independently associated with adverse events, with hemoglobin level emerging as a determinant. Further research is warranted to determine whether BP stabilization can improve the prognosis of HFpEF.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"871-881"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Unpacking the Link between Income, Smoking, and Dementia Risk: Insights and Opportunities.","authors":"Jie V Zhao","doi":"10.31662/jmaj.2025-0231","DOIUrl":"10.31662/jmaj.2025-0231","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"777-778"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Disaster Preparedness: The Role of Hazard Map Awareness among Individuals with Physical Disabilities.","authors":"Kyo Takahashi, Kenji Takaki, Shutaro Koyama, Jun Suzurikawa","doi":"10.31662/jmaj.2024-0347","DOIUrl":"10.31662/jmaj.2024-0347","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"965-969"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rigler's Triad Another Challenge to Remember.","authors":"Vitorino Modesto Dos Santos, Kin Modesto Sugai","doi":"10.31662/jmaj.2025-0075","DOIUrl":"10.31662/jmaj.2025-0075","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"1011-1012"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Rigler's Triad Another Challenge to Remember\".","authors":"Ryohei Ono, Izumi Kitagawa","doi":"10.31662/jmaj.2025-0096","DOIUrl":"10.31662/jmaj.2025-0096","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"1013-1014"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Pleasure and Difficulties among Older Patients: Primary Care Setting in Japan.","authors":"Junki Mizumoto, Hirohisa Fujikawa, Masashi Izumiya, Masato Eto","doi":"10.31662/jmaj.2025-0002","DOIUrl":"10.31662/jmaj.2025-0002","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults undergo physical and social changes that adversely affect their health. However, the prevalence and distribution of patients' pleasure and difficulties remain poorly documented. Moreover, the acceptability and feasibility of self-administered questionnaires concerning their social conditions among older patients are still uncertain. Our study aimed to elucidate the distribution of daily pleasure and difficulties among older patients and assess the acceptability of these screenings.</p><p><strong>Methods: </strong>Descriptive epidemiology was conducted at a single center in Japan. From April 2023 to March 2024, self-reported questionnaires on activities of daily living (ADL), daily pleasure and difficulties, and the acceptability of these questions were distributed to all patients aged 80 years or older. The participants' long-term care (LTC) certification level, a nationwide measure in Japan, was used to assess their ADL.</p><p><strong>Results: </strong>A total of 359 patients participated, with 192 (53.5%) not applying for LTC certification, 57 (15.9%) at Support Levels, and 101 (28.1%) at Care Need Levels. Among them, 242 (67.4%) reported daily pleasures, 56 (15.6%) experienced bathing difficulties, 73 (20.3%) encountered excretion problems, and 34 (9.4%) faced excessive financial burdens. These difficulties and financial burdens were more prevalent among those at Support Levels and Care Need Levels than those without LTC certifications. Most participants found these surveys acceptable.</p><p><strong>Conclusions: </strong>Participants requiring LTC reported daily pleasures as frequently as those without LTC certification. However, those requiring LTC more frequently reported difficulties in daily activities and faced excessive financial burdens. Healthcare professionals should inquire about older patients' specific daily living needs.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"846-852"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and Outcomes Attributable to Weaning and Decannulation from Ventilation after Tracheostomy.","authors":"Ichita Kinoshita, Masaaki Higashino, Masataka Taniuchi, Tetsuya Terada, Takeshi Tochizawa, Ryo Kawata, Shin-Ichi Haginomori","doi":"10.31662/jmaj.2024-0439","DOIUrl":"10.31662/jmaj.2024-0439","url":null,"abstract":"<p><strong>Introduction: </strong>The goal of tracheostomy in patients with long-term tracheal intubation is to facilitate weaning from mechanical ventilation (MV), achieve decannulation, and ultimately enable discharge to home. In this study, we investigated the factors influencing withdrawal from MV after tracheostomy and cannulation in patients undergoing long-term tracheal intubation. We also examined tracheostomy status (whether the tracheostomy tube was removed and whether the patient was weaned from MV) and discharge outcomes.</p><p><strong>Methods: </strong>A total of 199 patients who underwent tracheostomy following long-term tracheal intubation were analyzed. Patients were classified into 3 groups based on tracheostomy status: group A (tracheostomy tube removed; n = 35); group B (tracheostomy tube not removed despite weaning from MV; n = 76); and group C (weaning from MV not achieved; n = 88).</p><p><strong>Results: </strong>The duration of intensive care unit stay did not differ significantly among the groups. However, hospital stay was significantly shorter in group C than in groups A and B. Additionally, the rate of discharge to home was significantly higher in group A. Factors associated with difficulty in weaning from MV included a blood lymphocyte count <500, the presence of chest and abdominal disease, and a body mass index ≥30. Factors contributing to with difficulty in decannulation after weaning from MV included head and neck disease, age ≥75 years, C-Reactive Protein ≥5, and a blood lymphocyte count <500.</p><p><strong>Conclusions: </strong>Weaning from MV and decannulation are key factors influencing discharge to home in patients undergoing tracheostomy after long-term intubation. These factors are primarily affected by the patient's underlying disease and general condition. We believe that addressing these factors through nutritional management, rehabilitation, and other supportive measures can improve the quality of life and increase the likelihood of discharge to home.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"817-824"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Music Listening Habits and Auditory Functions in Medical College Students.","authors":"Tomoyasu Ishida, Jun Suzuki, Takeshi Sato, Tetsuya Oishi, Yohei Honkura, Ryoukichi Ikeda, Yukio Katori","doi":"10.31662/jmaj.2025-0016","DOIUrl":"10.31662/jmaj.2025-0016","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of hearing impairment in young adults and raising social awareness of preventive measures are essential to mitigate the negative impact on individuals' quality of life and reduce the societal costs associated with hearing impairment. This study investigated the music listening habits of medical college students using audiological function tests to assess their impact on young adults' hearing functions.</p><p><strong>Methods: </strong>We recruited 77 healthy volunteers who underwent a comprehensive assessment, including a questionnaire on music listening habits, pure-tone audiometry (PTA), tympanometry, extended high-frequency (EHF) audiometry, and loudness discomfort level (LDL) tests. Furthermore, we measured preferred music listening levels (PMLs). The association between music listening habits and PMLs and the results of various auditory function tests were examined.</p><p><strong>Results: </strong>Among the 77 participants, 60 were men, and 17 were women, with a median age of 23 years. All participants exhibited a mean hearing threshold of less than 25 dB HL on PTA. Sixty-six (85.7%) participants used earphones/headphones daily, with a median usage duration of 2.0 hours. The correlations between the duration of earphones/headphones usage, EHF thresholds, and LDLs were not significantly different. The correlation between the duration of earphones/headphones usage and PMLs was weakly positive (r = 0.2772). A stronger positive correlation (r = 0.4625) was observed when focusing on 23 participants with high LDL values.</p><p><strong>Conclusions: </strong>The positive correlation between the duration of earphones/headphones usage and PMLs suggested that inappropriate music listening habits might synergistically act as risk factors for hearing impairment in young adults.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"799-808"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Asymptomatic Juvenile Emphysema.","authors":"Taro Koba, Shuichi Matsuda, Miake Yamamoto, Mikio Takamori","doi":"10.31662/jmaj.2025-0042","DOIUrl":"10.31662/jmaj.2025-0042","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"981-983"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Molecular Mechanism of Parturition and the Establishment of a Safe Obstetrical Care System - Secondary Publication.","authors":"Tadashi Kimura","doi":"10.31662/jmaj.2025-0099","DOIUrl":"10.31662/jmaj.2025-0099","url":null,"abstract":"<p><p>The article presents the research and social implementation efforts undertaken by my colleagues and me at the Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine. We cloned the human oxytocin receptor using molecular biology techniques and investigated its transcriptional regulatory mechanisms in the human uterus during parturition. Additionally, we adapted a mouse placenta-specific gene expression system to develop a preeclampsia model and explored potential therapeutic strategies. Our research also focused on improving surgical techniques for peripartum hysterectomy in cases of critical obstetric hemorrhage and vasa praevia with placenta praevia, which may also lead to sudden fetal death during parturition. Concurrently, based on epidemiological data, we adopted a social approach strengthening obstetric care teams and identifying key issues within Japan's delivery system. Furthermore, we developed a web-based postpartum care procedure. I hope that research and practices aimed at enhancing maternal safety and well-being will continue to progress further in the future.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"699-702"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}