Showing papers by "Mitsumasa Kishimoto published in 2013"

The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan.

Abstract: Background It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven.

Differences in clinical manifestations, treatment, and concordance rates with two major sets of criteria for Behçet’s syndrome for patients in the US and Japan: data from a large, three-center cohort study

Abstract: Objective To compare Behcet’s syndrome (BS) cohorts from the US and Japan in terms of rates of concordance with the International Study Group (ISG) criteria and Japanese criteria, disease manifestations, and treatment.

Use of data from multiple registries in studying biologic discontinuation: challenges and opportunities

Abstract: Many studies have been conducted concerning discontinuation of biologic disease-modifying anti-rheumatic drugs (DMARD), but mainly in trial settings which result in limited generalisability. Registry studies can complement the current literature of biologic DMARD discontinuation by providing more generalisable information. However, it may be necessary to combine registries to increase power and provide more diverse patient populations. This increased power could provide us information about risk and benefits of discontinuing biologic DMARD in typical clinical practice. However, use of multiple registries is not without challenges. In this review, we discuss the challenges to combining data across multiple registries, focusing on biologic discontinuation as an example. Challenges include: 1) generalizability of each registry; 2) new versus prevalent users designs; 3) outcome definitions; 4) different health care systems; 5) different follow up intervals; and 6) data harmonisation. The first three apply to each registry, and the last three apply to combining multiple registries. This review describes these challenges, corresponding solutions, and potential future opportunities.

Experience with the use of hydroxychloroquine for the treatment of lupus erythematosus

Abstract: Hydroxychloroquine (HCQ) is generally used to treat systemic lupus erythematosus (SLE) in Western countries. However, chloroquine retinopathy became a problem in Japan, and chloroquine has never been used since then. Even now HCQ remains non-approved. Therefore, the Japanese Hydroxychloroquine Study Group has been organized, and activities have started to have HCQ approved within Japan. In the present study, we investigated the effectiveness of HCQ against the skin manifestations of lupus erythematosus. There were seven patients, all female, and they consisted of four patients with SLE (skin lesion type: discoid lupus erythematosus [DLE] in three, subacute cutaneous lupus erythematosus in one and lupus erythematosus profundus in one), two patients with cutaneous lupus erythematosus (both DLE), and one patient with a combination of SLE and dermatomyositis. HCQ was effective in three patients and ineffective in the two patients. We could not judge the efficacy of HCQ in the other two patients. There were no adverse effects in any of the patients. Efficacy was exhibited against telangiectasia and erythema. HCQ is also an effective and safe treatment for Japanese patients, and it is hoped that it will be approved for use in Japan very soon.

Infliximab for Behçet disease with aortic involvement: two novel case reports without concurrent use of immunosuppressive agents or corticosteroids.

Abstract: Behcet disease (BD) is a multisystem inflammatory disorder presenting with mucocutaneous, ocular, musculoskeletal, and neurological involvement. Vascular involvement is seen in about one fourth of BD patients, with a predilection for veins [1]. The frequency of arterial lesions is relatively low, ranging from 1 % to 33.5 % of all vascular involvement [2], and the mortality rate for BD patients with arterial involvement is reported to be higher than for those without arterial disease [3]. Among several immunosuppressive agents, antitumor necrosis factor (anti-TNF) agents are increasingly used in patients with refractory BD [4, 5]. In cases of vascular involvement, there have been only few case reports or small studies showing efficacy of infliximab (IFX) in combination with corticosteroids and/or immunosuppressants [6]. Here, we describe two novel cases of BD with aortitis successfully treated by IFX without corticosteroids or immunosuppressants.

Comment on Predictors of preterm birth in patients with mild systemic lupus erythematosus by Clowse et al

Abstract: Clowse et al 1 report that ferritin, oestradiol and uric acid level at mid-gestation may predict preterm delivery in systemic lupus erythematosus (SLE) with mild-moderate disease activity. This is a well-done study, but we believe that the authors fail to …