Impact of polypharmacy on clinical outcomes in patients with advanced heart failure undergoing cardiac resynchronization therapy.

Background: The prevalence rates of heart failure (HF) and hyperpolypharmacy have increased with the aging population. While a negative impact of hyperpolypharmacy on HF clinical outcomes has already been reported, the effects of hyperpolypharmacy on patients with advanced HF with reduced ejection fraction (HFrEF) undergoing cardiac resynchronization therapy (CRT) remain unclear.

Methods: We retrospectively evaluated data from 147 patients with advanced HFrEF who underwent CRT between March 2004 and June 2020.

Recent Advances and New Therapeutic Goals in the Management of Severe Asthma.

Asthma is characterized by chronic airway inflammation as its primary pathological condition, which leads to various respiratory symptoms due to airway narrowing, with type 2 inflammation playing a central role. Asthma treatment, primarily centered on inhaled corticosteroids, aims to suppress type 2 inflammation and improve airway narrowing. However, severe asthma that cannot be controlled with high-dose inhaled corticosteroids or other asthma medications remains a clinical issue.

Feasibility of long-range telesurgical robotic radical gastrectomy in a live porcine model.

Background: Telesurgery has been made increasingly possible with the advancements in robotic surgical platforms and network connectivity. However, long-distance transnational complex robotic surgeries such as gastrectomy have yet to be attempted.

Methods: Multiple transnational network connections by Science Innovation Network (SINET), Japan Gigabit Network (JGN), and Arterial Research and Education Network in Asia-Pacific (ARENA-PAC) were established and tested by multiple surgeons in a dry box model.

Pregestational BMI Over 23 kg/m2 May Increase Insulin Utilization in Gestational Diabetes Mellitus Patients.

The purpose of this study is to examine the pregestational BMI value that results in insulin use in Japanese patients with gestational diabetes mellitus (GDM) and to assess whether the type of GDM treatment affects postpartum glucose tolerance. This retrospective study included 21 GDM patients treated until parturition at our department from 2013 to 2017. We calculated the pregestational BMI related to insulin treatment and the significant elevation in homeostasis model assessment of insulin resistance (HOMA-IR) by receiver operating characteristics curve (ROC) analysis.

Risk factors for anastomotic leakage in rectal cancer surgery reflecting current practices.

Purpose: In recent years, major advancements have been made in rectal cancer surgery with the introduction of new techniques such as robotic surgery and indocyanine green fluorescence imaging (ICG-FI). This study aimed to evaluate the comprehensive risk factors for anastomotic leakage (AL) following rectal cancer surgery, incorporating recently introduced techniques and other existing factors, to reflect current practices.

Methods: A retrospective analysis was conducted of 304 patients who underwent either robotic or laparoscopic anterior resection between January 2019 and December 2023.