Search

Objectives: Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence. Methods: Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan–Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin. Results: The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high‐adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC. Conclusion: Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia. [ABSTRACT FROM AUTHOR]

Featured Application: The present study found a significant relationship between the prevalence of skin symptom exacerbations and the concentration of particulate matter 2.5 and its ionic components. A few studies have evaluated this topic, so the present study may be an important stepping stone for future research. (1) Background: To date, little research has epidemiologically examined whether the concentration of particulate matter (PM) 2.5 and its ionic components is related to the prevalence of skin symptom exacerbations. Therefore, this study aimed to clarify this association in patients with allergic diseases. (2) Methods: From 1 February to 31 May 2020, we evaluated the daily prevalence of skin symptoms in outpatients with allergic diseases being treated at Fukuoka National Hospital, Fukuoka, Japan, and measured the concentration of PM2.5 and its ionic components. (3) Results: Univariate analysis showed a statistically significant association between skin symptoms and the concentration of PM2.5 and the ionic components SO42−, NH4+, K+, and Mg2+; multivariate analysis showed a statistically significant association between the daily prevalence of skin symptom and the concentration of the ionic components SO42− or Mg2+. (4) Conclusions: Our findings indicate that the concentration of some PM2.5 ionic components may affect skin symptom in patients with allergic diseases. [ABSTRACT FROM AUTHOR]

To estimate the connectivity of a road network, it is crucial to evaluate the correlation of hazard intensities among individual bridge locations since the probability of multiple bridges being damaged simultaneously depends on the degree of this correlation. However, research on connectivity assessment of bridge networks considering spatial correlations associated with flood intensities is scarce in the literature. When quantifying the spatial correlation of flood intensities, modeling based on the stream distance rather than the Euclidean distance is required, taking into account that river flow is restricted only within the stream network. To achieve this purpose, a novel methodology is proposed to evaluate the spatial correlation of a stream network based on a geostatistical linear model and stream network covariance models. In addition, this study considers the spatial correlation of seismic hazard intensity. With the proposed method, it is possible to identify which bridges play an important role in ensuring the connectivity of the road network under multiple hazards, i.e. flood and seismic. As an illustrative example, the proposed method is applied to a hypothetical bridge network in Kumamoto Prefecture, Japan. The results demonstrate that improved network connectivity can be achieved by implementing a relevant retrofitting strategy for important bridges. [ABSTRACT FROM AUTHOR]

Objectives: Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia‐specific QOL in RTX patients. Methods: The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia‐related QOL questionnaires (N‐QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N‐QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia‐specific QOL in patients post‐RTX. Results: The mean nocturia frequency post‐RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p =.042). Aging significantly decreased the total N‐QOL score and the Sleep/Energy domain score (p =.001 and.0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p =.018 and.037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N‐QOL. Conclusions: Nocturia‐specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia‐specific QOL in RTX patients. [ABSTRACT FROM AUTHOR]

Escherichia coil pgsA mutations, which cause acidic phospholipid deficiency, repress transcription of the flagellar master operon flhDC, and thus impair flagellar formation and motility. The molecular mechanism of the strong repression of flhDC transcription in the mutant cells, however, has not yet been clarified. In order to shed light on this mechanism we isolated genes which, when supplied in multicopy, suppress the repression of flhD, and found that three genes, gadW, metE and yeaB, were capable of suppression. Taking into account a previous report that gadW represses [[sigma].sup.S] production, the level of [[sigma].sup.S] in the pgsA3 mutant was examined. We found that pgsA3 cells had a high level of [[sigma].sup.S] and that introduction of a gadW plasmid into pgsA3 cells did reduce the [[sigma].sup.S] level. The pgsA3 cells exhibited a sharp increase in s levels that can only be partially attributed to the slight increase in rpoS transcription; the largest part of the effect is due to a post-transcriptional accumulation of [[sigma].sup.s]. GadW in multicopy exerts its effect by post- transcriptionally downregulating [[sigma].sup.S]. YeaB and MetE in multicopy also exert their effect via [[sigma].sup.s]. Disruption of rpoS caused an increase of the flhD mRNA level, and induction from [P.sub.trc]-rpoS repressed the flhD mRNA level. The strong repression of flhD transcription in pgsA3 mutant cells is thus suggested to be caused by the accumulated [[sigma].sup.s]. DOI 10.1099/mic.0.036749-0