Longterm Safety of Tocilizumab: Results from 3 Years of Followup Postmarketing Surveillance of 5573 Patients with Rheumatoid Arthritis in Japan.

Objective: To evaluate the longterm safety of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Japan.

Methods: In this longterm extension of a single-arm, observational postmarketing surveillance study, a total of 5573 patients who initiated intravenous TCZ between April 2008 and July 2009 were observed for 3 years, regardless of its continuation, for incidence of fatal events, serious infections, malignancy, gastrointestinal perforations, and serious cardiac dysfunction.

Results: Of the 5573 patients who were enrolled, 4527 patients (81.

Comparing Patient and Physician Risk Tolerance for Bleeding Events Associated with Anticoagulants in Atrial Fibrillation-evidence from the United States and Japan.

Objectives: Atrial fibrillation (AF) is a factor in the development of thrombi that can lead to ischemic strokes. Anticoagulants are crucial in preventing strokes among patients with AF but are associated with bleeding risks. Recent studies have shown that despite anticoagulants' efficacy in stroke prevention, many patients with AF receive subtherapeutic levels of anticoagulation because of concerns about bleeding.

The safety of fish oils for those whose risk of injury is high.

A diet rich in omega-3 polyunsaturated fatty acids (PUFAs) may decrease risk of cardiovascular disease by improving the blood lipid profile. The purpose of this review was to (1) determine if fish oil (omega-3) consumption increased the risk of hemorrhaging after a military injury and (2) whether an improvement in the omega-3 PUFA profile had an impact on survivability from military wounds. The authors found no evidence to contradict the existing U.

Warfarin anticoagulation intensity in Japanese nonvalvular atrial fibrillation patients: a J-RHYTHM Registry analysis.

Background: To maximize protection against stroke with minimal bleeding, warfarin therapy in nonvalvular atrial fibrillation (NVAF) requires tight control within a narrow therapeutic range, which might depend on racial variations.

Methods: The J-RHYTHM Registry followed 6404 NVAF patients treated with warfarin for 2 years. Using international normalized ratios (INRs) at or closest to the embolic and intracranial hemorrhagic (ICH) events, we determined odds ratios for ischemic stroke/systemic embolism (SE) and ICH according to any given INR with a reference INR range including 2.

Clinical importance of adherence to treatment with eicosapentaenoic acid by patients with hypercholesterolemia.

Background: Despite the risk of critical heart disease, poor adherence to treatment is common in patients with lifestyle-related diseases such as hypercholesterolemia. The association between adherence to treatment and clinical outcome was examined in JELIS (Japan EPA Lipid Intervention Study) and strategies for avoiding poor adherence were explored.

Methods And Results: Patients taking 80% or more of the study medications were considered to exhibit good adherence.

The Japan Thrombosis Registry for Atrial Fibrillation, Coronary or Cerebrovascular Events (J-TRACE): a nation-wide, prospective large cohort study; the study design.

Background: A previous history of myocardial infarction (MI), stroke, and the presence of atrial fibrillation (AF) are known risk factors for the onset of arterial thromboembolic events such as MI and ischemic stroke. To clarify the rate of incidence of such events for these high-risk patients in Japan, a nation-wide cohort study was conducted that was named the 'Japan Thrombosis Registry of Atrial Fibrillation, Coronary and Cerebrovascular Events' (ie, J-TRACE) [UMIN Registered ID C000000189].

Methods And Results: In the J-TRACE registry, a total of 8,093 Japanese patients with either a history of stroke and/or MI or patients with non-valvular AF were registered.

Essential polyunsaturated fatty acids and social cognition in schizophrenia.

Abnormal metabolism of essential polyunsaturated fatty acids (EPUFAs), a component of phospholipids in neural membranes, has been suggested to be related to the pathophysiology of schizophrenia. The purpose of this study was to examine the relationship between EPUFA concentrations in erythrocyte membranes, a peripheral measure of phospholipid composition in the brain, and clinical variables, such as cognitive performance relevant to social functions, in patients with schizophrenia. Erythrocyte membrane levels of EPUFAs, saturated fatty acids, and monounsaturated acids were measured in 25 patients with schizophrenia and 32 age- and gender-matched 32 normal volunteers.

Anomalous cerebral asymmetry in patients with schizophrenia demonstrated by voxel-based morphometry.

Background: Evaluating cerebral asymmetry in schizophrenia patients potentially leads to understanding the extent to which the disorder involves a neurodevelopmental failure. We sought to clarify in which brain regions of the patient the normal cerebral asymmetry is disrupted and the extent of disruption.

Methods: Voxel-based morphometry to evaluate gray matter asymmetry was carried out with magnetic resonance images from a total of 120 right-handed subjects.

Electrical brain activity and response to olanzapine in schizophrenia: a study with LORETA images of P300.

The aim of this study was to evaluate the change in the distribution for the P300 generator, as demonstrated by Low Resolution Electromagnetic Tomography (LORETA) images, in patients with schizophrenia during treatment with olanzapine. Data were obtained from five right-handed patients treated with olanzapine for 6 months. Five right-handed normal volunteers also participated in the study.

Role of 5-HT(1A) receptors in the modulation of stress-induced lactate metabolism in the medial prefrontal cortex and basolateral amygdala.

Rationale: Lactate has been shown to play a significant role in energy metabolism and reflect neural activity in the brain.

Objectives: Using in vivo microdialysis technique, we measured extracellular lactate concentrations in the medial prefrontal cortex (mPFC) and the basolateral amygdaloid (BLA) nucleus of rats under electric foot shock stress. Moreover, to examine the role of serotonin (5-HT)(1A) receptors in brain energy metabolism in response to stressors, we attempted to determine whether the stress-induced changes of extracellular lactate levels in the mPFC and BLA are attenuated by tandospirone, a partial agonist at 5-HT(1A) receptors, or perospirone, a novel atypical antipsychotic with a 5-HT(1A) receptor partial agonist and 5-HT(2A)/dopamine-D(2) antagonist property.

Verbal memory deficits in a preadolescent case of lesions of the left parahippocampal gyrus associated with a benign tumor.

The authors report cognitive functions of a 13-year-old boy with a cavernous angioma occupying the posterior left parahippocampal gyrus (PHG) and part of the left fusiform gyrus but not hippocampus. Neuropsychological examinations soon after the removal of the tumor showed selective deficits in semantic memory function, as evaluated by the Category Fluency Task and the Wechsler Memory Scale-Revised, while visual memory, attention, and IQ were not affected. These observations suggest the involvement of the PHG in the processing of semantic memory and provide an insight into the neural substrates underlying the distinct cognitive deficits in some of the psychiatric diseases such as schizophrenia.

Enhancement of lactate metabolism in the basolateral amygdala by physical and psychological stress: role of benzodiazepine receptors.

Lactate is considered to play a significant role in energy metabolism and reflect neural activity in the brain. Using in vivo microdialysis technique, we measured extracellular lactate concentrations in the basolateral amygdaloid nucleus (BLA) of rats under electric footshock or psychological stress. We also attempted to determine whether the stress-induced changes of extracellular lactate concentrations in the BLA are attenuated by diazepam, an agonist at benzodiazepine receptors, and whether FG7142, an inverse agonist at benzodiazepine receptors, have a facilitative effect on energy metabolism in the BLA.