Kanako Kurihara

Bio: Kanako Kurihara is an academic researcher from Fukuoka University. The author has contributed to research in topics: Medicine & Parkinson's disease. The author has an hindex of 3, co-authored 11 publications receiving 14 citations.

Attitudes toward telemedicine of patients with Parkinson’s disease during the COVID-19 pandemic

Abstract: COVID‐19 had spread all over the world by the end of 2019. In Japan, the government declared a state of emergency in March 2020. Although no study has reported it in detail, patients with Parkinson's disease (PD) can be vulnerable to COVID‐19, because they have poor respiratory excursion. Telemedicine is a very effective way of reducing the risk of COVID‐19 infection, as well as reducing the physical, economic, and psychological burden on patients.

A case of drug-induced hypersensitivity syndrome induced by salazosulfapyridine combined with SIADH caused by interstitial pneumonia.

Abstract: We present a case of a patient with drug-induced hypersensitivity syndrome (DIHS) caused by salazosulfapyridine combined with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) caused by interstitial pneumonia (IP). A 67-year-old man with a past history of rheumatism (RA) presented with right hemiparalysis and aphasia as the chief complaints. A diagnosis of left embolic cerebral infarction following trial therapy for RA based on computed tomography findings was made, and external decompression was performed. Salazosulfapyridine was newly started on day 7. Dabigatran was started on day 37. On day 41, the patient developed fever. On day 42, edema and erythema appeared on his face, and erythema and rash appeared on his trunk and extremities, with gradual transition to erythroderma. The drug eruption was initially attributed to the dabigatran. Various symptoms of organ dysfunction (enteritis, myocarditis, interstitial pneumonia, hepatic disorder, stomatitis, and others) then appeared and persisted; hence, a diagnosis of DIHS associated with human herpes virus 6 and cytomegalovirus infection induced by salazosulfapyridine was suggested, and the oral administration of salazosulfapyridine was discontinued on day 53. Hyponatremia was observed in association with exacerbation of IP. Due to low serum osmotic pressure and prompt improvement of the serum sodium level by fluid restriction, the SIADH was attributed to IP. In this case, steroid pulse therapy followed by gradual decrease therapy prevented worsening of the condition.

Efficacy and safety evaluation of safinamide as an add-on treatment to levodopa for Parkinson's disease.

Abstract: Introduction While levodopa is still the most effective treatment for Parkinson's disease, concerns about long-term complications such as wearing-off and dyskinesia with levodopa usage remain. Areas covered : Safinamide is a highly selective and reversible monoamine oxidase B inhibitor introduced in the European Union, Japan, and the United States as an adjunctive agent to levodopa in PD patients with motor fluctuation. This review outlines the pharmacological properties, therapeutic effects, and tolerability of safinamide as an adjunct to levodopa in patients with advanced PD. Efficacy and safety findings from double-blind and placebo-controlled clinical trials for safinamide as an adjunct therapy to levodopa for PD are summarized. Expert opinion : Safinamide was well tolerated as a treatment for PD, and there was no significant difference in the frequency and severity of adverse events between the safinamide and placebo groups. It was also suggested that safinamide had a beneficial effect on the accompanying non-motor symptoms such as PD-related pain. Safinamide may exhibit neuroprotective effects through antioxidant and anti-glutamate effects, and research on the disease-modifying effect of PD is desired in the future.

Evaluation of motor complications in Parkinson’s disease: understanding the perception gap between patients and physicians

Abstract: Background: Patients with Parkinson’s disease (PD) receiving levodopa treatment often report the motor complications including wearing-off (WO), dyskinesia and morning akinesia phenomena. Since motor complications are associated with a decrease in patient quality of life (QoL), it is important to identify its occurrence and commence immediate management. This study investigated whether differences in the perception of motor complications exist between patients and their physicians in routine clinical practice.Methods: Following an internet-based screening survey, questionnaires were distributed to physicians and their patients in Japan. The 9-item Wearing-off Questionnaire (WOQ-9) assessed the presence of WO objectively; patients with WOQ-9 scores ≥2 were considered to have WO. McNemar’s tests were used to compare physician assessment with the WOQ-9, patient self-awareness with physician assessment, and patient self-awareness with the WOQ-9, separately. Morning akinesia, dyskinesia, and QoL were also assessed.Results: A total of 235 patients with PD and their 92 physicians participated in this survey. A significant discordance was observed between the WOQ-9 and physician assessment of WO (67.2% vs 46.0%; p<0.0001). Furthermore, patient self-awareness of WO was 35.3% (p=0.0004, vs physician). Morning akinesia (patient, 58.7%; physician, 48.9%; p=0.0032), dyskinesia (patient, 34.0%; physician, 23.4%; p=0.0006), and bodily discomfort (patient, 25.0; physician, 0.0; p=0.0102) of QoL were underrecognized by physicians. Conclusions: This study investigated differences in the perception of WO between patients with PD and their physicians in routine clinical practice and highlighted that patients have a low awareness of the symptoms of WO compared with physician assessments and the WOQ-9. Conversely, morning akinesia, dyskinesia, and bodily discomfort were underrecognized by physicians.

A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies

Abstract: From N Engl J Med, Hideaki Tsukuma, Akihisa Imagawa, M.D., Toshiaki Hanafusa, M.D., Ph.D., Jun-ichiro Miyagawa, M.D., Ph.D., and Yuji Matsuzawa, M.D., Ph.D., A Novel Subtype of Type 1 Diabetes Mellitus Characterized by a Rapid Onset and an Absence of Diabetes-Related Antibodies, 342:301-307. Copyright © 2000 Massachusetts Medical Society. Reprinted with permission.

Syndrome of inappropriate secretion of antidiuretic hormone

Abstract: Hyponatremia is a commonly encountered electrolyte abnormality in clinical practice and in some groups of patients is associated with significant morbidity and mortality. Although the pathophysiology of this disturbance is complex, its understanding is vital to the disorder's evaluation and treatment. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the commonest form of euvolemic hyponatremia and is the clinical and biochemical manifestation of a wide range of disease processes, mostly associated with malignancy, pulmonary, or neurologic disorders, and of pharmacotherapy. Symptoms vary depending on the severity of hyponatremia and, if occur, can range from weakness, mild headache, muscle cramps, nausea, and vomiting to convulsions, coma, and death. Identifying the underlying disorder remains an integral part of the diagnostic evaluation of patients. The most frequently used treatment options include water restriction, oral intake of salt, hypertonic saline and vaptans, being nonpeptide vasopressin antagonists interfering with the antidiuretic effect of the hormone. The aim of our paper is to present a practical diagnostic approach and management of SIADH, with a particular emphasis on the results of recent studies.

“Heart in DRESS”: Cardiac Manifestations, Treatment and Outcome of Patients with Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome: A Systematic Review

Abstract: Cardiac involvement in drug reaction with eosinophilia and systemic symptoms (DS) is rare but associated with high mortality. The aim of this research was to systematically review case reports by PRISMA guidelines in order to synthetize the knowledge of cardiac manifestations of DS. We identified 42 cases from 36 case reports. Women were two times more affected than men. Two-thirds of patients had cardiac manifestation in the initial phase of the disease, while in one-third of cases cardiac manifestations developed later (mean time of 70 ± 63 days). The most common inciting medications were minocycline (19%) and allopurinol (12%). In 17% of patients, the heart was the only internal organ affected, while the majority (83%) had at least one additional organ involved, most commonly the liver and the kidneys. Dyspnea (55%), cardiogenic shock (43%), chest pain (38%), and tachycardia (33%) were the most common cardiac signs and symptoms reported. Patients frequently had an abnormal ECG (71.4%), and a decrease in left ventricular ejection fraction was the most common echocardiographic finding (45%). Endomyocardial biopsy or histological examination at autopsy was performed in 52.4%, with the predominant finding being fulminant eosinophilic myocarditis with acute necrosis in 70% of those biopsied. All patients received immunosuppressive therapy with intravenous steroids, while non-responders were more likely to have received IVIG, cyclosporine, mycophenolate, and other steroid-sparing agents (60%). Gender and degree of left ventricular systolic dysfunction were not associated with outcomes, but short latency between drug exposure and the first DRESS symptom onset (<15 days) and older age (above 65 years) was associated with death. This underscores the potential importance of heightened awareness and early treatment.