7 results on '"Kiyosawa J"'
Search Results
2. Effects of 6-month administration of tofogliflozin on cardiac function in elderly patients with heart failure with preserved ejection fraction: A retrospective study of a patient cohort.
- Author
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Higashikawa T, Ito T, Mizuno T, Ishigami K, Kuroki K, Haraguchi T, Yamada S, Sangen R, Kiyosawa J, Saito A, Iguchi M, Nakahashi T, Kasamaki Y, Fukuda A, Kanda T, and Okuro M
- Subjects
- Humans, Retrospective Studies, Aged, Male, Female, Aged, 80 and over, Echocardiography, Glomerular Filtration Rate drug effects, Heart Failure drug therapy, Heart Failure physiopathology, Benzhydryl Compounds administration & dosage, Benzhydryl Compounds therapeutic use, Benzhydryl Compounds pharmacology, Glucosides administration & dosage, Glucosides therapeutic use, Glucosides pharmacology, Stroke Volume drug effects, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 physiopathology, Sodium-Glucose Transporter 2 Inhibitors administration & dosage, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors pharmacology
- Abstract
Patients with type 2 diabetes mellitus are frequently hospitalized for heart failure. The ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e'), measured by echocardiography, is a simple and convenient indicator of diastolic dysfunction. Various large clinical trials have reported that sodium glucose transporter-2 inhibitor therapy reduced cardiovascular events and hospitalizations in heart failure patients. We examined the effect of tofogliflozin on various physiological and cardiac function. A retrospective analysis was performed on elderly patients aged 65 years or older with type 2 diabetes mellitus attending Himi Municipal Hospital who were taking oral tofogliflozin 20 mg/day. Measurement of physiological and hormonal variables, blood sampling, and echocardiographic evaluations at 0, 1, 3, and 6 months were performed on those with ejection fraction (EF) of 40% or greater at the time of treatment. Statistical analysis was performed using t-tests and mixed-effects models, with brain natriuretic peptide less than or not less than 100 pg/mL, estimated glomerular filtration rate (eGFR) less than or not less than 50 mL/min/1.73 m2, and diuretics administered or not. Hypoglycemic effects were observed at 0, 1, 3, and 6 months. At each time point, EF was retained and E/e' was significantly reduced. On the other hand, most physiological parameters and laboratory results showed no clinical abnormalities. Mixed-effects models showed time-dependent reduction of E/e' in high/low brain natriuretic peptide, high/low eGFR, with or without diuretics between baseline and at 6 months. The interaction with time was significant in high/low eGFR. Tofogliflozin was shown to improve E/e', a measure of diastolic function, while maintaining EF, with hypoglycemic effects and no clinical side effects., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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3. Synthesis of Dicarboxylic Acids Comprising an Ether Linkage and Cyclic Skeleton and Its Further Application for High-Performance Aluminum Electrolyte Capacitors.
- Author
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Mizota I, Yamamoto T, Kaliyamoorthy S, Shimizu M, Rathinam B, Liu BT, Kuroki N, Kiyosawa J, and Tanaka H
- Abstract
Aluminum electrolytic capacitors are essential components in all electronic devices, and it is known that their longevity depends on the performance of their electrolytes. We synthesized dicarboxylic acids having ether bonds showing the good solubility in ethylene glycol as a solvent and simultaneously developed a complete halogen removal method, which is strictly prohibited in capacitors. Moreover, the incorporation of bulky α-substituents and cyclic structures dramatically improved their heat resistance and can withstand high voltage, i.e., 764 V., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)
- Published
- 2024
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4. The Impact of Tofogliflozin on Physiological and Hormonal Function, Serum Electrolytes, and Cardiac Diastolic Function in Elderly Japanese Patients with Type 2 Diabetes Mellitus.
- Author
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Higashikawa T, Ito T, Mizuno T, Ishigami K, Kuroki K, Maekawa N, Usuda D, Izumida T, Yamada S, Sangen R, Hamada K, Kiyosawa J, Saito A, Iguchi M, Kasamaki Y, Nakahashi T, Fukuda A, Saito H, Kanda T, and Okuro M
- Subjects
- Humans, Aged, Glycated Hemoglobin, Blood Glucose, Sodium-Glucose Transporter 2 therapeutic use, Retrospective Studies, East Asian People, Electrolytes therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Sodium-Glucose Transporter 2 Inhibitors pharmacology, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
The sodium glucose transporter 2 (SGLT2) inhibitor tofogliflozin is a glucose-lowering drug that causes the excretion of surplus glucose by inhibiting SGLT2. Because of tofogliflozin's osmotic diuresis mechanism, patients' serum electrolytes, body fluid levels, and cardiac function must be monitored. We retrospectively analyzed the cases of 64 elderly Japanese patients with type 2 diabetes mellitus (T2DM) who received tofogliflozin for 3 months. Their HbA1c, serum electrolytes (sodium, potassium, chloride), hematocrit, brain natriuretic peptide (cardiac volume load marker) and renin and aldosterone (RAA; an index of regulatory hormones involved in body fluid retention) were continuously monitored during the investigation period. Renal function and cardiac function (by echocardiography) were assessed throughout the period. HbA1c significantly decreased (β1=-0.341, p<0.0001, linear regression analysis [LRA]). Most of the hormonal, electrolyte, and physiological parameters were maintained throughout the study period. In these circumstances, E/e' tended to decrease (β1=-0.382, p=0.13, LRA). Compared to the baseline, E/e' was significantly decreased at 1 and 3 months (p<0.01, p<0.05). In the higher E/e' group (E/e'≥10, n=34), E/e' decreased significantly (β1=-0.63, p<0.05, LRA). ΔE/e' was correlated with body-weight change during treatment (r=0.64, p<0.01). The 3-month tofogliflozin treatment improved glycemic control and diastolic function represented by E/e' in T2DM patients, without affecting serum electrolytes, renal function, or RAA. No negative impacts on the patients were observed. Three-month tofogliflozin treatment lowered glucose and improved cardiac diastolic function., Competing Interests: No potential conflict of interest relevant to this article was reported.
- Published
- 2022
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5. A new predictive tool consolidating CURB-65 with procalcitonin and albumin to assess short-term mortality in hospitalized elderly patients with infectious disease: A retrospective study of a patient cohort.
- Author
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Higashikawa T, Ito T, Mizuno T, Ishigami K, Kuroki K, Maekawa N, Usuda D, Nakao S, Hamada K, Takagi S, Terada N, Takeshima K, Yamada S, Sangen R, Izumida T, Kiyosawa J, Saito A, Iguchi M, Wato H, Nakahashi T, Kasamaki Y, Fukuda A, Kanda T, and Okuro M
- Subjects
- Humans, Aged, Retrospective Studies, Biomarkers, Albumins, Procalcitonin, Communicable Diseases
- Abstract
Background: Hospitalized elderly patients are often at risk of life-threatening infectious diseases such as pneumonia and urinary tract infection, thus diagnostic tools for bacterial infections are demanded. We developed a new predictive tool consolidating modified CURB-65, procalcitonin (PCT) and albumin (Alb)., Method: This is a retrospective study. Modified CURB-65 (mCURB-65) score, PCT, Alb, and various cardiovascular/respiratory/renal functions were measured. Survival analyses were conducted to assess 30-days mortality of elderly patients using mCURB-65 score, PCT and Alb. The consolidated scores were compared with the number of patients died., Results: There were 445 elderly patients included. Kaplan-Meier survival curves showed significant differences between the high and low groups of mCURB-65, PCT and Alb (log-rank test, P < .001). Cox proportional regression showed that the hazard ratios (95% confidence intervals) for high mCURB-65, high Alb, and high PCT were all significant, 1.95 (1.24-3.05), 0.50 (0.32-0.77), and 2.09 (1.32-3.31), respectively. The consolidated scores showed tendency of increase with proportion of the number of patients died., Conclusions: The consolidated score consisted of mCURB-65, PCT and Alb can be a useful tool to predict short-term mortality of the hospitalized elderly patients with infectious disease., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2022
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6. Effects of tofogliflozin on adrenocorticotropic hormone, renin and aldosterone, and cortisol levels in elderly patients with diabetes mellitus: A retrospective study of a patient cohort.
- Author
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Higashikawa T, Ito T, Mizuno T, Ishigami K, Kuroki K, Maekawa N, Usuda D, Morita T, Hamada K, Takagi S, Takeshima K, Yamada S, Sangen R, Izumida T, Mori H, Kiyosawa J, Saito A, Iguchi M, Nakahashi T, Kasamaki Y, Fukuda A, Kanda T, and Okuro M
- Subjects
- Adrenocorticotropic Hormone, Aged, Benzhydryl Compounds, Glucosides, Humans, Hydrocortisone, Renin, Retrospective Studies, Aldosterone, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Abstract: Adrenocorticotropic hormone (ACTH) and cortisol reportedly play a role in glycemic control in patients with type 2 diabetes mellitus (T2DM); however, the underlying mechanism remains controversial. We retrospectively investigated the effect of tofogliflozin on serum ACTH and cortisol levels in elderly patients with T2DM.Patients received 20 mg tofogliflozin daily for 3 months. Serum ACTH and cortisol levels were measured at baseline, as well as after 1 month and 3 months of tofogliflozin therapy.Serum ACTH levels were significantly reduced 3 months after tofogliflozin treatment (P < .01). Additionally, serum cortisol levels were reduced 3 months after tofogliflozin treatment, demonstrating borderline significance (P = .05). The higher body mass index (BMI; ≥25 kg/m2) group showed higher ACTH and cortisol levels than the lower BMI (<25 kg/m2) group, with borderline significance (P = .05). Renin levels were significantly increased 1 month after treatment (P < .05), maintaining serum aldosterone levels in parallel with the extracellular fluid.Our findings suggested that tofogliflozin decreased both serum ACTH and cortisol levels, with higher levels observed in the high BMI group. Tofogliflozin increased serum renin levels while maintaining serum aldosterone and extracellular fluid levels. Collectively, tofogliflozin could affect the hypothalamic-pituitary-adrenal pathway in patients with T2DM, especially in the low BMI group., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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7. Infective endocarditis following tumor necrosis factor-α antagonist therapy for management of psoriatic erythroderma: a case report.
- Author
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Mizuno T, Kiyosawa J, Fukuda A, Watanabe S, Kurose N, Nojima T, and Kanda T
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- Aged, Brain Infarction microbiology, Dermatitis, Exfoliative complications, Dermatologic Agents adverse effects, Endocarditis complications, Fatal Outcome, Humans, Infliximab adverse effects, Male, Prednisolone adverse effects, Brain Infarction pathology, Dermatitis, Exfoliative drug therapy, Dermatologic Agents administration & dosage, Endocarditis drug therapy, Infliximab administration & dosage, Prednisolone administration & dosage, Tumor Necrosis Factor-alpha antagonists & inhibitors
- Abstract
Background: The introduction of biological agents, such as infliximab, which act against tumor necrosis factor-α was a major advance for the treatment of an increasing number of chronic diseases. Tumor necrosis factor-α antagonists represent a major therapeutic advance for the management of chronic inflammatory diseases, such as psoriasis. Previous studies have reported that the use of tumor necrosis factor-α antagonists increased the risk of opportunistic infections and reactivation of latent bacterial infections. Cardiac involvement, such as infective endocarditis, is very rare in the literature., Case Presentation: A 77-year-old Asian man with a 10-year history of psoriatic erythroderma was referred due to high fever and general malaise. He was treated with Predonine (prednisolone) and infliximab. After treatment, cardiac echography showed mitral valve vegetation and brain magnetic resonance imaging indicated multiple fresh infarctions. He died from large brain infarction in October 2013. An autopsy showed fresh thrombosis in his left middle cerebral artery, mitral valve vegetations, and septic micro-embolisms in multiple organs., Conclusions: Lethal bacterial endocarditis was revealed after administration of tumor necrosis factor-α inhibitor, infliximab, for the treatment of psoriatic erythroderma. An autopsy showed vegetation in his mitral valve and brain infarction with fresh purulent embolism in his left middle cerebral artery and septic micro-embolisms.
- Published
- 2017
- Full Text
- View/download PDF
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