BACKGROUND:Despite the potential association between Kawasaki Disease (KD) and coronavirus disease 2019 (COVID-19), real-world clinical associations remain unclear. We aimed to investigate the association between KD and COVID-19 using a Japanese claims database. METHODS:Using a Japanese claims database, we identified patients diagnosed with COVID-19 between January 1, 2020, and December 31, 2022 and conducted the following two analyses: a nested case-control study wherein each KD case was matched 1:4 to controls (without KD), and conditional logistic regression analyses were used to calculate odds ratios (ORs) for COVID-19 exposure in the previous 1-30, 31-60, and 61-90 days. In the self-controlled case-series (SCCS) analysis, the observation comprised the 120 days before and after COVID-19 diagnosis (Day 0). We calculated the incidence rate ratio (IRR) of three risk periods (Days 1-30, 31-60, 61-90) after Day 0 compared with the control periods. RESULTS:Nested case-control analysis matched 134 cases with 536 controls. COVID-19 exposure was identified in 26.1% (35/134) of cases and 7.3% (39/536) of controls during the previous 1-30 days (adjusted OR 7.8, 95% CI 3.2-19), and in 18.7% (25/134) and 8.8% (47/536) during the previous 31-60 days (adjusted OR 3.6, 95% CI 2.0-6.5). SCCS analysis included 124 patients, revealing elevated IRRs on Days 1-30 (95% CI: 11 [6.0-20]), and 31-60 (6.9 [3.6-13]) after COVID-19 diagnosis. CONCLUSION:The present study found that COVID-19 was associated with the development of KD.
Abstract Background To investigate immune-related adverse events (irAEs) in patients with non-small cell lung cancer receiving immune checkpoint inhibitor (ICI) therapy, and to identify clinical factors associated with irAE onset, thus supporting safer immunotherapy through effective monitoring. Methods This retrospective cohort study was conducted at Tohoku Medical and Pharmaceutical University Hospital over approximately 5 years. Hospitalized patients with non-small cell lung cancer who received immune checkpoint inhibitors for the first time were included. Physicians and pharmacists evaluated the occurrence, severity, and timing of irAEs. Cox proportional hazards regression and Fine–Gray competing risk analyses were performed to identify factors associated with irAE development. Results Among the 203 enrolled patients, 92 (45.3%) experienced irAEs, totaling 110 events. The most common irAE was interstitial lung disease (23 cases, 20.9%), followed by thyroid dysfunction (20 cases, 18.2%). In multivariable Cox regression analysis, comorbid heart failure was significantly associated with a reduced risk of irAE development (hazard ratio, 0.299; 95% confidence interval [CI], 0.135–0.663; p = 0.003), and this association remained significant in the Fine–Gray competing risk model (subdistribution hazard ratio, 0.335; 95% CI, 0.147–0.766; p = 0.009). To address potential multicollinearity, an alternative model incorporating regular use of renin–angiotensin–aldosterone system inhibitors in place of comorbid heart failure also demonstrated a significant association with irAE incidence. Conclusions In this Japanese non-small cell lung cancer cohort, comorbid heart failure emerged as a potential modifier of irAE incidence, suggesting that baseline cardiac conditions may influence susceptibility to immune‑related toxicity. These findings underscore the importance of incorporating comorbidity profiles into individualized irAE monitoring strategies during cancer immunotherapy.
Objectives:This study structurally analyzed physiotherapists' activity outcomes dispatched via the Japan International Cooperation Agency (JICA) volunteer program, aiming to develop future strategies for physiotherapy education, practice, and global health engagement. Methods:We analyzed Reports 1-5 from 123 JICA-dispatched physiotherapists (2014-2024), focusing primarily on the "activity outcomes" section of Report 5 using KH Coder for text mining. Additional variables, such as year of dispatch, gender, host country, geographic region, and number of physiotherapists at the placement site, were extracted. Regions were divided into 5 categories: Asia, Africa, Oceania, Latin America and the Caribbean, and Central Asia and the Middle East. Frequency and hierarchical cluster analyses were also performed. Utilizing clustering patterns, activity outcomes were classified into 8 categories. External variables-region and staffing levels-were used for cross-tabulations. Results:The study grouped outcomes into 2 main types: 4 categories reflecting direct support through clinical practice and technology transfer, and 3 categories representing institutional and organizational contributions rooted in logical problem solving. The small effect sizes indicated that external factors had limited influence on activity outcomes, such as a greater use of the community-based rehabilitation (CBR) approach in Latin America and areas with limited physiotherapy personnel. Conclusions:These findings indicate that JICA volunteer physiotherapists consistently fulfilled core professional roles across diverse contexts, emphasizing clinical support, capacity development, and system improvement. Despite regional and contextual differences, the weak effect sizes suggest that individual adaptability and shared professional values contribute to sustaining context-appropriate rehabilitation practices in global health settings.
INTRODUCTION:Ritodrine hydrochloride has been widely used in Japan to treat threatened preterm labor, often beyond the internationally recommended short-term duration. Accumulating evidence has demonstrated limited benefits and raised safety concerns regarding prolonged ritodrine administration, and a declining trend in its use has been documented through 2021. However, prescribing trends following the March 2021 revision of the ritodrine package insert remain unclear. Here, we investigated recent nationwide trends in ritodrine prescriptions among pregnant women in Japan from 2015 to 2024, with particular focus on trends after 2021, and examined differences according to route of administration and healthcare setting. METHODS:Administrative data on pregnant Japanese women who visited acute-care Diagnosis Procedure Combination (DPC) hospitals between January 1, 2015, and December 31, 2024, were used in this study. The analysis focused on ritodrine products marketed in Japan. The prevalence of ritodrine prescriptions was analyzed, and temporal trends were assessed using the Cochran-Armitage trend test. Stratified analyses were performed according to age group, hospital bed capacity, and hospital type. RESULTS:Among hospitalized pregnant women, the prevalence of oral ritodrine prescriptions decreased from 22.0% to 17.2% (absolute decrease of 4.8 percentage points, p < 0.001) during the study period (2015-2024), whereas that of injectable ritodrine prescriptions decreased from 37.6% to 25.0% (absolute decrease of 12.6 percentage points, p < 0.001). Among pregnant outpatients, the prevalence of oral ritodrine prescriptions decreased from 58.5% to 34.5% (absolute decrease of 24.0 percentage points, p < 0.001), whereas that of injectable ritodrine prescriptions increased slightly from 0.42% to 0.46% (absolute increase of 0.04 percentage points, p = 0.01), although outpatient injectable ritodrine prescribing remained below 1% throughout the study period. The decline was more pronounced for oral ritodrine prescriptions than for injectable ritodrine prescriptions. CONCLUSION:Ritodrine prescriptions among pregnant women in Japan decreased between 2015 and 2024 for both oral and injectable formulations in hospitalized settings and for oral formulations in outpatient settings. The decline continued after the 2021 package insert revision, suggesting ongoing changes in prescribing practices related to prolonged ritodrine use.
