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Clinical Response to Valproate in Patients with Migraine
Mizuki Ichikawa,Hirotaka Katoh,Tatsuya Kurihara,Masakazu Ishii 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.4
Background and Purpose Valproate is used as a prophylactic drug for migraine, but it is not be effective in all patients. We used medical records to investigate which clinical factors affected the response to valproate in patients with migraine as an original headache, and estab-lished a scoring system for predicting the clinical response to prophylactic therapy. Methods We investigated clinical factors from the medical records of 95 consistent respond¬ers (CRs) and 24 inconsistent responders (IRs) to valproate. Results Multivariate stepwise logistic regression analysis revealed that a history of hyperlip¬idemia and hay fever and the complication of depression or other psychiatric disorder were significant factors that independently contributed to a negative response, with odds ratios of 6.024 [no vs. yes; 95% confidence interval (CI)=1.616–22.222], 2.825 (no vs. yes; 95% CI= 1.046–7.634), and 2.825 (no vs. yes; 95% CI=1.052–7.576), respectively. A predictive index (PI) of the clinical response to valproate in patients with migraine was calculated using the regres¬sion coefficients of these three factors as an integer, and the index was significantly higher for IRs than for CRs (1.46±1.10 vs. 0.69±0.74, mean±SD, p<0.001). Conclusions The obtained PI may represent an appropriate scoring system for predicting the responses in these patients.
Combination of a SARS-CoV-2 IgG Assay and RT-PCR for Improved COVID-19 Diagnosis
Aoki Kotaro,Takai Kunitomo,Nagasawa Tatsuya,Kashiwagi Katsuhito,Mori Nobuaki,Matsubayashi Keiji,Satake Masahiro,Tanaka Ippei,Kodama Nanae,Shimodaira Takahiro,Ishii Yoshikazu,Miyazaki Taito,Ishii Toshi 대한진단검사의학회 2021 Annals of Laboratory Medicine Vol.41 No.6
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is generally diagnosed by reverse transcription (RT)-PCR or serological assays. The SARS-CoV-2 viral load decreases a few days after symptom onset. Thus, the RT-PCR sensitivity peaks at three days after symptom onset (approximately 80%). We evaluated the performance of the ARCHITECT® SARS-CoV-2 IgG assay (henceforth termed IgG assay; Abbott Laboratories, Lake County, IL, USA), and the combination of RT-PCR and the IgG assay for COVID-19 diagnosis. Methods: In this retrospective study, 206 samples from 70 COVID-19 cases at two hospitals in Tokyo that were positive using RT-PCR were used to analyze the diagnostic sensitivity. RT-PCR-negative (N=166), COVID-19-unrelated (N=418), and Japanese Red Cross Society (N=100) samples were used to evaluate specificity. Results: Sensitivity increased daily after symptom onset and exceeded 84.4% after 10 days. Specificity ranged from 98.2% to 100% for samples from the three case groups. Seroconversion was confirmed from 9 to 20 days after symptom onset in 18 out of 32 COVID-19 cases with multiple samples and from another case with a positive result in the IgG assay for the first available sample. Conclusions: The combination of RT-PCR and IgG assay improves the robustness of laboratory diagnostics by compensating for the limitations of each method.