Conventional and Kampo Medicine Treatment for Mild-to-moderate COVID-19: A Multicenter, Retrospective, Observational Study by the Integrative Management in Japan for Epidemic Disease (IMJEDI Study-observation).

Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37°C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

The Relationship between "Shofuku-Fujin" (Abnormality of Abdominal Examination in Japanese Kampo Medicine) and Body Composition by Bioelectrical Impedance Analysis: A Cross-Sectional Study.

Shofuku-fujin is an abnormal physical finding in Kampo medical practice. It is assumed to be often found in the elderly and contributes to the selection of Kampo formulas used mainly in elderly patients. However, few objective reports about Shofuku-fujin have been published to date. The aim of this study was to clarify the clinical features of patients showing Shofuku-fujin by using bioelectrical impedance analysis (BIA) and to objectively assess the potential clinical implications of these findings. We conducted a cross-sectional study of 1330 patients who visited our institute to undergo a medical examination by using data collected from September 2010 to March 2016. We extracted data on patient sex and age, anthropometric data, and body composition data that could potentially affect the appearance of Shofuku-fujin. Logistic regression analyses were performed by sex to analyze the various factors related to the appearance of Shofuku-fujin. Of the 1330 patients, the data of 386 men and 942 women were used for analysis. Multivariate logistic regression analysis showed that Shofuku-fujin was associated with older age (odds ratio (OR), 1.07; 95% confidence interval (CI), 1.05-1.10; p < 0.001), lower skeletal muscle mass index (SMI) (OR, 0.60; 95% CI, 0.43-0.85; p = 0.004), and lower body fat percentage (OR, 0.89; 95% CI, 0.85-0.93; p < 0.001) in men and older age (OR, 1.06; 95% CI, 1.04-1.07, p < 0.001) and lower body fat percentage (OR, 0.94; 95% CI, 0.92-0.96; p < 0.001) in women. On the basis of these results, the factors causing the appearance of Shofuku-fujin were aging, decreased muscle mass, and decreased body fat in men and aging and decreased body fat in women. Our results demonstrated that it may be better to consider a loss of muscle mass when examining a male patient with Shofuku-fujin.

Immunohistochemical localization of phospholipase A2 in the guinea pig nasal mucosa.

OBJECTIVE: Phospholipase A2 (PLA2) is a key enzyme in arachidonic acid metabolism, which is involved in the maintenance of biological homeostasis and the onset of various diseases. The immunohistochemical localization of PLA2 in the nasal mucosa has not been reported, even though the presence of messenger RNA of PLA2 has been demonstrated in the human nasal brush sample. The present study was designed to determine the localization of PLA2s in the nasal cavity. METHODS: The immunohistochemichal localization of secretory PLA2 (sPLA2) and cytosolic PLA2 (cPLA2) in the nasal mucosa was studied using adult guinea pig. RESULTS: Both sPLA2 and cPLA2 were localized in the nasal gland as well as the respiratory epithelium, and not in the surrounding vascular endothelial cells, olfactory gland, olfactory epithelium or submucosal tissue. CONCLUSION: Our data provide the first convincing evidence that both sPLA2 and cPLA2 are significantly expressed in the nasal gland and the respiratory epithelium, and are suggested to regulate the function of the nasal mucosa, such as bactericidal, Na secretion, and allergic response.

[Peritonsillar abscess associated with infectious mononucleosis: retrospective study of three cases].

Three cases with infectious mononuculeosis associated with peritonsillar abscess were reviewed. The initial diagnoses in these three cases were tonsillitis or peritonsillitis. However, infectious mononucleosis was suspected because of an elevation in aminotransferases and was later confirmed by elevations in the titers of antibodies for Epstein-Barr virus. Peritonsillar abscesses developed and surgical drainage was performed in all three cases. The present study suggests a higher incidence of peritonsillar abscess in patients with infectious mononucleosis than previously expected.