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1.  Inhibition of emotional needs and emotional wellbeing predict disease progression of chronic hepatitis C patients: an 8-year prospective study 
The role of psycosocial factors in the disease progression of chronic hepatitis C (CHC) patients remains unclear. The aim of the present study was to prospectively evaluate the prognostic value of behavioral patterns and the quality of life (QOL) of patients with CHC.
Two hundred and forty Japanese CHC patients (mean age 62.4 years) were assessed for behavioral patterns (Stress Inventory), QOL (Functional Assessment of Chronic Illness Therapy-Spiritual), and known prognostic factors at baseline then followed for a maximum of 8 years for disease progression, defined as either the first diagnosis of hepatocellular carcinoma (HCC) or hepatitis-related death.
Forty-nine events occurred during the study period (46 newly diagnosed HCC cases, three hepatitis-related deaths). In a Cox proportional hazard model including known prognostic factors and treatment-related factors as time-dependent variables, behavioral patterns associated with inhibition of emotional needs (hazard ratio (HR): 1.35; 95 % confidence interval (CI): 1.02–1.77; p = 0.036) and QOL, representing emotional wellbeing (HR 0.60; 95 % CI 0.37–0.98; p = 0.041), were each associated with the risk of disease progression.
Psychosocial factors such as behavioral patterns relevant to the inhibition of emotional needs and emotional wellbeing independently affect the clinical course of patients with CHC.
Electronic supplementary material
The online version of this article (doi:10.1186/s13030-016-0075-3) contains supplementary material, which is available to authorized users.
PMCID: PMC4966853  PMID: 27478498
Chronic hepatitis; Psychosocial stress; Quality of life; Emotion; Hepatocellular carcinoma; Prognosis
2.  Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial 
Sakata, Yasuhiko | Shiba, Nobuyuki | Takahashi, Jun | Miyata, Satoshi | Nochioka, Kotaro | Miura, Masanobu | Takada, Tsuyoshi | Saga, Chiharu | Shinozaki, Tsuyoshi | Sugi, Masafumi | Nakagawa, Makoto | Sekiguchi, Nobuyo | Komaru, Tatsuya | Kato, Atsushi | Fukuchi, Mitsumasa | Nozaki, Eiji | Hiramoto, Tetsuya | Inoue, Kanichi | Goto, Toshikazu | Ohe, Masatoshi | Tamaki, Kenji | Ibayashi, Setsuro | Ishide, Nobumasa | Maruyama, Yukio | Tsuji, Ichiro | Shimokawa, Hiroaki | Shimokawa, H. | Fukuchi, M. | Goto, T. | Hiramoto, T. | Inoue, K. | Kato, A. | Komaru, T. | Ohe, M. | Sekiguchi, N. | Shiba, N. | Shinozaki, T. | Sugi, M. | Tamaki, K. | Hiramoto, T. | Inoue, K. | Kato, A. | Ogata, M. | Sato, S. | Sugi, M. | Ishide, N. | Ibayashi, S. | Maruyama, Y. | Ohno, I. | Tamaki, K. | Ogawa, H. | Kitakaze, M. | Tsuji, I. | Watanabe, T. | Sugiyama, K. | Oyama, S. | Nozaki, E. | Nakamura, A. | Takahashi, T. | Endo, H. | Fukui, S. | Nakajima, S. | Nakagawa, M. | Nozaki, T. | Yagi, T. | Horiguchi, S. | Fushimi, E. | Sugai, Y. | Takeda, S. | Fukahori, K. | Aizawa, K. | Ohe, M. | Tashima, T. | Sakurai, K. | Kobayashi, T. | Goto, T. | Matsui, M. | Tamada, Y. | Yahagi, T. | Fukui, A. | Takahashi, K. | Takahashi, K. | Kikuchi, Y. | Akai, K. | Kanno, H. | Kaneko, J. | Suzuki, S. | Takahashi, K. | Akai, K. | Katayose, D. | Onodera, S. | Hiramoto, T. | Komatsu, S. | Chida, M. | Iwabuchi, K. | Takeuchi, M. | Yahagi, H. | Takahashi, N. | Otsuka, K. | Koseki, Y. | Morita, M. | Shinozaki, T. | Ishizuka, T. | Onoue, N. | Yamaguchi, N. | Fujita, H. | Katoh, A. | Namiuchi, S. | Sugie, T. | Saji, K. | Takii, T. | Sugimura, A. | Ohashi, J. | Fukuchi, M. | Ogata, M. | Tanikawa, T. | Kitamukai, O. | Matsumoto, Y. | Inoue, K. | Koyama, J. | Tomioka, T. | Shioiri, H. | Ito, Y. | Kato, H. | Takahashi, C. | Kawana, A. | Sakata, Y. | Ito, K. | Nakayama, M. | Fukuda, K. | Takahashi, J. | Miyata, S. | Sugimura, K. | Sato, K. | Matsumoto, Y. | Nakano, M. | Shiroto, T. | Tsuburaya, R. | Nochioka, K. | Yamamoto, H. | Aoki, T. | Hao, K. | Miura, M. | Kondo, M. | Tatebe, S. | Yamamoto, S. | Suzuki, H. | Nishimiya, K. | Yaoita, N. | Sugi, M. | Yamamoto, Y. | Toda, S. | Minatoya, Y. | Takagi, Y. | Hasebe, Y. | Nihei, T. | Hanawa, K. | Fukuda, K. | Sakata, Y. | Takahashi, J. | Miyata, S. | Nochioka, K. | Miura, M. | Tadaki, S. | Ushigome, R. | Yamauchi, T. | Sato, K. | Tsuji, K. | Onose, T. | Abe, R. | Saga, C. | Suenaga, J. | Yamada, Y. | Kimura, J. | Ogino, H. | Oikawa, I. | Watanabe, S. | Saga, M. | Washio, M. | Nagasawa, K. | Nagasawa, S. | Kotaka, S. | Komatsu, W. | Hashimoto, R. | Ikeno, Y. | Suzuki, T. | Hamada, H.
European Heart Journal  2015;36(15):915-923.
We examined whether an additive treatment with an angiotensin receptor blocker, olmesartan, reduces the mortality and morbidity in hypertensive patients with chronic heart failure (CHF) treated with angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or both. In this prospective, randomized, open-label, blinded endpoint study, a total of 1147 hypertensive patients with symptomatic CHF (mean age 66 years, 75% male) were randomized to the addition of olmesartan (n = 578) to baseline therapy vs. control (n = 569). The primary endpoint was a composite of all-cause death, non-fatal acute myocardial infarction, non-fatal stroke, and hospitalization for worsening heart failure. During a median follow-up of 4.4 years, the primary endpoint occurred in 192 patients (33.2%) in the olmesartan group and in 166 patients (29.2%) in the control group [hazard ratio (HR) 1.18; 95% confidence interval (CI), 0.96–1.46, P = 0.112], while renal dysfunction developed more frequently in the olmesartan group (16.8 vs. 10.7%, HR 1.64; 95% CI 1.19–2.26, P = 0.003). Subgroup analysis revealed that addition of olmesartan to combination of ACE inhibitors and β-blockers was associated with increased incidence of the primary endpoint (38.1 vs. 28.2%, HR 1.47; 95% CI 1.11–1.95, P = 0.006), all-cause death (19.4 vs. 13.5%, HR 1.50; 95% CI 1.01–2.23, P = 0.046), and renal dysfunction (21.1 vs. 12.5%, HR 1.85; 95% CI 1.24–2.76, P = 0.003). Additive use of olmesartan did not improve clinical outcomes but worsened renal function in hypertensive CHF patients treated with evidence-based medications. Particularly, the triple combination therapy with olmesartan, ACE inhibitors and β-blockers was associated with increased adverse cardiac events. This study is registered at
PMCID: PMC4466154  PMID: 25637937
Heart failure; Hypertension; Angiotensin II receptor blocker; Olmesartan
3.  Effect of 12 weeks of yoga training on the somatization, psychological symptoms, and stress-related biomarkers of healthy women 
Previous studies have shown that the practice of yoga reduces perceived stress and negative feelings and that it improves psychological symptoms. Our previous study also suggested that long-term yoga training improves stress-related psychological symptoms such as anxiety and anger. However, little is known about the beneficial effects of yoga practice on somatization, the most common stress-related physical symptoms, and stress-related biomarkers. We performed a prospective, single arm study to examine the beneficial effects of 12 weeks of yoga training on somatization, psychological symptoms, and stress-related biomarkers.
We recruited healthy women who had no experience with yoga. The data of 24 participants who were followed during 12 weeks of yoga training were analyzed. Somatization and psychological symptoms were assessed before and after 12 weeks of yoga training using the Profile of Mood State (POMS) and the Symptom Checklist-90-Revised (SCL-90-R) questionnaires. Urinary 8-hydroxydeoxyguanosine (8-OHdG), biopyrrin, and cortisol levels were measured as stress-related biomarkers. The Wilcoxon signed-rank test was used to compare the stress-related biomarkers and the scores of questionnaires before and after 12 weeks of yoga training.
After 12 weeks of yoga training, all negative subscale scores (tension-anxiety, depression, anger-hostility, fatigue, and confusion) from the POMS and somatization, anxiety, depression, and hostility from the SCL-90-R were significantly decreased compared with those before starting yoga training. Contrary to our expectation, the urinary 8-OHdG concentration after 12 weeks of yoga training showed a significant increase compared with that before starting yoga training. No significant changes were observed in the levels of urinary biopyrrin and cortisol after the 12 weeks of yoga training.
Yoga training has the potential to reduce the somatization score and the scores related to mental health indicators, such as anxiety, depression, anger, and fatigue. The present findings suggest that yoga can improve somatization and mental health status and has implications for the prevention of psychosomatic symptoms in healthy women.
Trial registration
University Hospital Medical Information Network (UMIN CTR) UMIN000007868.
PMCID: PMC3892034  PMID: 24383884
Yoga; Somatization; Psychological symptom; Stress; Biomarker; Anxiety; Depression; Anger; Hostility; Fatigue
4.  Profile of mood states and stress-related biochemical indices in long-term yoga practitioners 
Previous studies have shown the short-term or intermediate-term practice of yoga to be useful for ameliorating several mental disorders and psychosomatic disorders. However, little is known about the long-term influences of yoga on the mental state or stress-related biochemical indices. If yoga training has a stress-reduction effect and also improves an individual's mental states for a long time, long-term yoga practitioners may have a better mental state and lower stress-related biochemical indices in comparison to non-experienced participants. This study simultaneously examined the differences in mental states and urinary stress-related biochemical indices between long-term yoga practitioners and non-experienced participants.
The participants were 38 healthy females with more than 2 years of experience with yoga (long-term yoga group) and 37 age-matched healthy females who had not participated in yoga (control group). Their mental states were assessed using the Profile of Mood States (POMS) questionnaire. The level of cortisol, 8-hydroxydeoxyguanosine (8-OHdG) and biopyrrin in urine were used as stress-related biochemical indices.
The average self-rated mental disturbance, tension-anxiety, anger-hostility, and fatigue scores of the long-term yoga group were lower than those of the control group. There was a trend toward a higher vigor score in the long-term yoga group than that in the control group. There were no significant differences in the scores for depression and confusion in the POMS between the two groups. The urine 8-OHdG concentration showed a trend toward to being lower in the long-term yoga group in comparison to the control group. There were no significant differences in the levels of urine biopyrrin or cortisol.
The present findings suggest that long-term yoga training can reduce the scores related to mental health indicators such as self-rated anxiety, anger, and fatigue.
PMCID: PMC3125330  PMID: 21635790

Results 1-4 (4)