Publications by authors named "NATORI Y"

Introduction: In Solid Organ Transplant (SOT) recipients, due to immunosuppression, the immunogenicity after COVID-19 vaccination is suboptimal and its durability is unknown.

Methods: We conducted a post-hoc analysis of a patient-blinded, single center, randomized controlled trial comparing BNT162b2 vs JNJ-78436735 as the third dose after two doses of BNT162b2 in adult SOT recipients with active graft to compare long-term immunogenicity.

Results: Forty-one recipients were analyzed.

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BRASH syndrome, characterized by bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia, is a recently identified syndrome typically caused by the interplay of electrolyte imbalances and medications such as beta-blockers and calcium channel blockers. This report presents the case of a 79-year-old woman with a history of epilepsy and hypertension, managed with carbamazepine, lamotrigine, and antihypertensive medications. She developed BRASH syndrome following reduced fluid intake and worsening renal function.

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  • Acute gastric dilatation (AGD) is a serious condition often linked to blockages or health issues like diabetes and eating disorders, and this report highlights a case involving a man who developed AGD after binge drinking.
  • The 46-year-old patient experienced severe vomiting and had a history of AGD due to excessive alcohol, and imaging confirmed gastric distension that improved with treatment.
  • This case emphasizes the need for healthcare providers to consider AGD in patients with vomiting after heavy drinking, as symptoms can easily be mistaken for other alcohol-related disorders.
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  • Solid organ transplant (SOT) recipients show poor antibody production against SARS-CoV-2 post-vaccination, raising concerns about their immune responses.
  • A study involving 614 SOT recipients vaccinated with mRNA vaccines revealed an overall seropositivity rate of 43% one month after the second dose, increasing to 70% by six months.
  • Kidney, lung, and simultaneous pancreas-kidney transplant recipients had lower antibody levels at 3 and 6 months compared to other organ types, indicating slower antibody acquisition relative to the general population.
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Cytomegalovirus (CMV) infection and disease are important causes of morbidity and mortality in transplant recipients. For the purpose of developing consistent reporting of CMV outcomes in clinical trials, definitions of CMV infection and disease were developed and most recently published in 2017. Since then, there have been major developments, including registration of new antiviral agents.

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  • The study investigates how variations in HLA alleles may lead to autoimmune diseases and their potential link to immune-related adverse events (irAEs), specifically thyroid issues in cancer patients.
  • A case-control study included 71 cancer patients treated with immune checkpoint inhibitors, comparing the frequency of specific HLA alleles between those with and without thyroid irAEs.
  • The findings show that certain HLA alleles were significantly more common in patients with thyroid irAEs, indicating a possible association between these genetic variations and the risk of developing such adverse events.
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Cytomegalovirus (CMV) reactivation is a major complication among seropositive allogeneic hematopoietic cell transplantation recipients; however, data on CMV reactivation after chimeric antigen receptor (CAR) T-cell therapy are limited. We report the incidence and outcomes of 95 adult CMV-seropositive patients who received CAR T-cell therapy between February 2018 and February 2023. CMV outcomes were CMV reactivation (any viremia) and clinically significant CMV infection (cs-CMV).

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  • Invasive aspergillosis (IA) is a serious and often fatal condition found in liver transplant recipients, with a 37% mortality rate over 12 weeks.
  • A study involving 62 IA cases and 124 controls identified key risk factors such as systemic antibiotic use and history of pneumonia that contribute to IA occurrence.
  • Factors like Aspergillus colonization and ICU stays significantly increased the risk of mortality among IA cases, while recent use of tacrolimus was found to be protective.
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complex (MABC), a rapidly growing , is one of the most common causes of non-tuberculous mycobacteria (NTM) infections in the United States of America, and it has been associated with a wide spectrum of infections in immunocompetent and immunosuppressed individuals. Eradicating MABC is very challenging, even with prolonged combination therapies. The management of MABC infections in solid organ transplant (SOT) patients is usually complex given their net state of immunosuppression, associated comorbidities, and potential drug-drug interactions, among other things.

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The excess mortality of coronavirus disease 2019 (COVID-19) solid organ transplant recipients (SOTRs) throughout the pandemic remains unclear. This prospective cohort study based on the Japanese nationwide registry included 1632 SOTRs diagnosed with COVID-19 between February 1, 2020, and July 31, 2022, categorized based on dominant phases of variants of concern (VOCs): Waves 1 to 3 (Beta), 4 (Alpha), 5 (Delta), 6 (Omicron BA.1/BA.

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  • The study focuses on comparing the immunogenicity of the COVID-19 vaccines BNT162b2 and mRNA1273 in solid organ transplant (SOT) recipients who are on immunosuppressive medication.
  • A total of 623 SOT recipients participated, with a final analysis comparing 100 participants who received each vaccine.
  • Results showed that mRNA1273 had significantly better immunogenicity compared to BNT162b2, particularly noticeable 3 months after the second dose.
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Global cerebral ischemia (GCI) caused by clinical conditions such as cardiac arrest leads to delayed neuronal death in the hippocampus, resulting in physical and mental disability. However, the mechanism of delayed neuronal death following GCI remains unclear. To elucidate the mechanism, we performed a metabolome analysis using a mouse model in which hypothermia (HT) during GCI, which was induced by the transient occlusion of the bilateral common carotid arteries, markedly suppressed the development of delayed neuronal death in the hippocampus after reperfusion.

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Anti-rejection medications are essential in preventing organ rejection amongst solid organ transplant recipients; however, these agents also cause profound immunosuppression, predisposing lung transplant recipients (LTRs) to infectious complications. The timely management including prevention, diagnosis, and treatment of such infectious complications is vital to prevent significant morbidity and mortality in solid organ transplant recipients and allograft dysfunction. LTRs are inundated with microbes that may be recognized as commensals in hosts with intact immune systems.

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Background: Isavuconazole (ISA) is a newer antifungal used in patients with history of hematologic malignancies and hematopoietic transplant and cellular therapies (HM/TCT). Although it has a more favorable side-effect profile, breakthrough invasive fungal infections (bIFIs) while on ISA have been reported.

Methods: In this single-center retrospective study evaluating HM/TCT patients who received prophylactic ISA for ≥7 days, we evaluated the incidence and potential risk factors for bIFIs.

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The opioid overdose crisis primarily driven by potent synthetic opioids resulted in more than 500,000 deaths in the US over the last 20 years. Though naloxone, a short-acting medication, remains the primary treatment option for temporarily reversing opioid overdose effects, alternative countermeasures are needed. Monoclonal antibodies present a versatile therapeutic opportunity that can be tailored to synthetic opioids and help prevent post-treatment renarcotization.

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The opioid overdose crisis primarily driven by potent synthetic opioids resulted in more than 500,000 deaths in the US over the last 20 years. Though naloxone, a short acting medication, remains the primary treatment option for temporarily reversing opioid overdose effects, alternative countermeasures are needed. Monoclonal antibodies present a versatile therapeutic opportunity that can be tailored for synthetic opioids and that can help prevent post-treatment renarcotization.

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Introduction: Variants in the galactosidase alpha () gene cause Fabry disease (FD), an X-linked lysosomal storage disorder caused by α-galactosidase A (α-GAL) deficiency. Recently, disease-modifying therapies have been developed, and simple diagnostic biomarkers for FD are required to initiate these therapies in the early stages of the disease. Detection of urinary mulberry bodies and cells (MBs/MCs) is beneficial for diagnosing FD.

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Background: Cytomegalovirus (CMV) infection is one of the most common posttransplantation infections and has been associated with increased rejection and mortality. Data in intestinal transplants recipients are limited.

Methods: This is a single-center, retrospective cohort study of all intestinal transplants performed between January 1, 2009, and August 31, 2020.

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Kidney disease affects millions of people worldwide. Chronic kidney diseases, such as diabetic nephropathy, are often accompanied by nephrotic syndrome, which causes a large amount of protein and lipid to leak out into the urine. Leaked lipids are well known to accumulate in the proximal tubules as lipid droplets.

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Solid Organ Transplant (SOT) recipients are at significant higher risk for COVID-19 and due to immunosuppressive medication, the immunogenicity after vaccination is suboptimal. In the previous studies, booster method showed significant benefit in this population. In the current study, we compared using a mix-and-match method vs.

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  • Multidrug-resistant (MDR) Gram-negative bacteria pose serious health risks, and timely treatment directly influences patient survival, which led to this study on enhancing therapy response times using new antibiotic combinations.* -
  • Researchers conducted a study on adult patients with severe infections from carbapenem-resistant Enterobacterales and MDR Pseudomonas, evaluating the effects of a new diagnostic and antimicrobial stewardship workflow implemented in 2019.* -
  • Results showed significant reduction in time to appropriate therapy (TAP), dropping from 103 hours to 75 hours, alongside a quicker turnaround in susceptibility testing, indicating the effectiveness of the improved workflow on patient outcomes.*
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  • This study looked at adult intestinal transplant recipients from 2016 to 2020, focusing on those with existing lung nodules to see if they were at higher risk for infections post-transplant.
  • Out of 44 patients, 31 had preexisting lung nodules, but only a few infections were noted after the transplant, including one case of probable invasive aspergillosis.
  • The study concluded that while many patients had nodules, they weren't directly linked to infections post-transplant, prompting recommendations for follow-up but not routine pretransplant scans for all patients.
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