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Introduction: This study aimed to estimate prevalence and incidence of attention deficit/hyperactivity disorder (ADHD) and comorbid relationships between ADHD and other psychiatric disorders in Japan. Methods: Using the real-world JMDC Claims Database, we conducted a cross-sectional study (analysis years 2017–2021) and retrospective cohort study (observation 2 years before/after the initial ADHD diagnosis; data collection 2005–2021; enrollment 2017–2019). Patients were male or female, aged 0–57 years. Cross-sectional study patients had an ADHD or other psychiatric disorder diagnosis (with or without medication) and were continuously registered in each analysis year; retrospective study patients had an ADHD diagnosis and ≥2 years' observation before and after diagnosis. Endpoints were annual prevalence and incidence of ADHD in Japan, prevalence and risk ratio of each psychiatric comorbidity in patients with ADHD, prevalence and risk ratios of ADHD in patients with each psychiatric comorbidity, and prevalence of psychiatric disorders before/after the initial ADHD diagnosis. Results: ADHD prevalence in children/adolescents and adults increased each year from 2017 to 2021. Prevalence in boys was 3.5–4.1 times higher than in girls. Prevalence in adults was lower than in children/adolescents, with a small sex difference. ADHD was highly comorbid with various psychiatric disorders. In 2019, the most common comorbidity in children/adolescents with ADHD was autism spectrum disorder (ASD; 54.4%); in adults, it was mood disorders (60.9%). ADHD prevalence in patients with various psychiatric disorders was higher than in the control population. ADHD prevalence was highest in patients with oppositional defiance disorder among both children/adolescents and adults (77.2% and 69.2%, respectively). In the retrospective cohort study (N = 14,940), the most common psychiatric disorders diagnosed prior to ADHD diagnosis were ASD in children/adolescents (33.9% of patients), and mood disorders and sleep disorders in adults (36.9% and 23.8% of patients, respectively). Discussion: ADHD was comorbid with various psychiatric disorders in Japan. In children and adolescents with ADHD, ASD was often diagnosed prior to ADHD. Psychiatric disorders, especially mood disorders and sleep disorders, were frequently diagnosed prior to the initial ADHD diagnosis in adults. The likelihood of comorbid ADHD should be considered when diagnosing adult patients with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: To explore persistence and adherence with once-daily, twice-daily, or once-weekly DPP-4 inhibitors (DPP-4i) in Japanese patients with type 2 diabetes.Methods: This retrospective, longitudinal, observational cohort study used data from the Japanese nationwide hospital-based Medical Data Vision (MDV) administrative claims database. Data were collected for patients given a new DPP-4i prescription between May 2015 and June 2017 with 1-year follow-up until May 2018. Treatment persistence was defined as the total duration of continuous prescription. Adherence to treatment was measured as the proportion of days covered (PDC).Results: A total of 598,419 patients with a prescription for DPP-4i treatment were identified in the MDV database. Of the 39,826 patients who met the inclusion criteria, 82.4% were receiving once-daily DPP-4i, 15.6% twice-daily DPP-4i, and 2.0% once-weekly DPP-4i. Twelve-month persistence rates with once-daily regimens were 66.3% versus 64.7% with twice-daily (p = .1187), and versus 38.8% with once-weekly, regimens (p < .0001) in the overall population (including untreated [UT] and previously treated [PT] patients); 62.8% with once-daily versus 58.3% with twice-daily (p = .0309), and versus 12.3% with once-weekly regimens (p < .0001) in the UT cohort; and 68.6% with once-daily versus 67.9% with twice-daily (p = .5471), and versus 49.1% with once-weekly regimens (p < .0001) in the PT cohort. In the overall population, 97.8% of patients had a mean PDC of 0.97 with once- and twice-daily, and 65.8% of patients had a mean PDC of 0.74 with once-weekly, DPP-4i regimens.Conclusions: Overall, persistence at 12 months was highest in patients receiving once-daily DPP-4i regimens. [ABSTRACT FROM AUTHOR]

The number of patients with heart failure (HF) is rapidly increasing. Although hypertension is related to onset of HF, antihypertensive treatment status for these patients has not been fully examined. We conducted a claims-based study to discern the treatment status of Japanese hypertensive patients with HF. Two Japanese databases (2008–2016) from acute care hospitals and health insurance societies were used to analyze prescription rates for antihypertensive drug class or category of diuretics in all hypertensive patients and the subset of patients with HF. Totals of hypertensive patients and those with HF in each database in 2015 were 4,191,666 and 1,404,008 patient-months, and 1,382,732 and 148,194 patient-months, respectively. In the acute care hospitals database, calcium channel blockers (CCBs) (55.0–56.5%) and angiotensin II receptor blockers (49.4–54.7%) were prescribed most. β-blockers (38.7–48.0%) and diuretics (42.3–45.6%) were prescribed more for hypertensive patients with HF than for all hypertensive patients (21.5–24.8% and 25.5–26.7%, respectively). Loop diuretics were also prescribed more often for hypertensive patients with HF (68.3–76.0% from acute care hospitals and 47.8–55.8% from health insurance societies) than for all hypertensive patients (56.7–61.7% and 16.4–18.3%). The size of medical institution had a greater effect on drug selection than patient age in both patient groups. Given recommendations in guidelines for hypertensive patients with HF, the differences in drug choice in comparison with all hypertensive patients appear reasonable. However, some deviations, such as the high rate of CCBs in frontline and preference for angiotensin II receptor blockers over angiotensin-converting enzyme inhibitors, did not appear to follow guidelines. [ABSTRACT FROM AUTHOR]

A 55-year-old man with a history of pancreatic cancer surgery and was undergoing chemotherapy presented with high fever. A computed tomography scan revealed a liver abscess at the location of a previously identified hemangioma. PTAD was performed, and contrast imaging revealed a connection with the bile duct. Edwardsiella tarda was detected in the abscess culture. Hemangioma-related abscess formation is extremely rare, with no reported cases of E. tarda detection in such abscesses.

Background: The mitochondrial K(ATP) channel (mitoK(ATP)) has been implicated as an end effector or trigger of ischemic preconditioning (IP). Although a mitoK(ATP) opener, diazoxide, mimics IP, mechanisms for the cardioprotective action remain unclear., Methods and Results: We measured Ca2+ transients (CaTs) and mitochondrial inner membrane potential (Deltapsi(m)) with confocal microscopy and the fluorescent probes fluo-4 and tetramethylrhodamine ethyl ester perchlorate in rat ventricular myocytes. Diazoxide increased the amplitudes and diastolic levels of CaTs dose dependently. The effects of diazoxide on CaTs were inhibited by the mitoK(ATP) antagonist sodium 5-hydroxydecanoic acid (100 micromol/L), whereas application of diazoxide caused little change in Deltapsi(m). After sarcoplasmic reticulum function was disabled with ryanodine and thapsigargin, the effects of diazoxide on CaTs were still observed. The opening of the mitochondrial permeability transition pore was monitored with fluorescent calcein. Diazoxide accelerated the leakage of calcein from mitochondrial matrix (16% of control; P<0.05), and this effect was inhibited by cyclosporin A (2 micromol/L). Cyclosporin A also abolished the effects of diazoxide on CaTs. Diazoxide oxidized flavoprotein fluorescence reversibly, and this effect was partially blunted by cyclosporin A (by 24%; P<0.05)., Conclusions: We conclude that in rat ventricular myocytes, diazoxide modulates the opening of the mitochondrial permeability transition pore, resulting in an increase in CaTs independent of the changes in Deltapsi(m). The action of diazoxide on the mitochondrial permeability transition pore also affects the mitochondrial redox state.