Publications by authors named "Tsunoda A"

Article Synopsis
  • Surgical treatment for diabetic foot ulcers (DFU) or chronic limb-threatening ischemia (CLTI) is complicated due to patients' poor health, making general anesthesia risky; therefore, peripheral nerve block with dexmedetomidine sedation is used in this study.
  • The study involved 18 patients and assessed sedation levels, intraoperative stress, and memory using various scales, showing effective sedation and low stress levels during surgery, though some patients experienced hypoxemia.
  • The findings indicate that using peripheral nerve block with dexmedetomidine can reduce patient stress and anxiety during surgery, but the potential for hypoxemia should be monitored closely.
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Objective: To evaluate the correlation between socioeconomic and healthcare factors and cervical cancer mortality rates, as well as the accessibility to prevention and treatment across Brazilian states and macroregions. The aim is to highlight the multifaceted challenge of addressing cervical cancer mortality, particularly in low- and middle-income countries.

Methods: This cross-sectional study analyzed public data from the Brazilian National Institute of Cancer (INCA), the National Institute of Geography and Statistics (IBGE), and the Brazilian Ministry of Health.

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  • The study examined the quality of life (QoL) of women with cervical cancer, emphasizing the importance of considering sexual health amid societal taboos surrounding the topic.
  • It compared long-term QoL outcomes among different treatment methods: chemotherapy/radiotherapy/brachytherapy, hysterectomy alone, and hysterectomy with radiotherapy, involving 131 patients.
  • Results indicated that patients who had isolated hysterectomy reported better QoL scores than those undergoing more aggressive therapies, highlighting the need for comprehensive care that includes addressing sexual concerns in survivorship.
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  • - A 57-year-old man was diagnosed with a mass in the sphenoid sinus and underwent surgery, which revealed a fast-growing testicular mass leading to bilateral visual loss shortly after.
  • - After emergency surgery and diagnosis of mantle cell lymphoma (MCL) affecting both the testis and sphenoid sinus, the patient received chemotherapy and corticosteroids.
  • - Post-treatment, he fully regained vision in his left eye, though the right remained lost, but he was able to return to normal social activities, marking an unusual case of MCL with such presentations.
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Objectives: To compare patients' self-administered responses to the Fecal Incontinence Severity Index (FISI) questionnaire (A1) with their responses to physician's oral interview (A3).

Methods: Patients (n=100: mean age: 72 years; 66 women) with FI completed the FISI and the modified FISI (with written explanations) questionnaires, followed by a physician interview. To identify a threshold for the rating gap between A1 and A3, we calculated each patient's mean difference in the FISI scores.

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  • Interest in cell transplantation therapy using human dental pulp cells (DPCs) is growing, but variations in cell characteristics impact their effectiveness for spinal cord injury (SCI).
  • A study showed that DPC clones improved the locomotor function in SCI rats, revealing that treatments like FGF2 and RTA402 can enhance cell resistance to harmful oxidants (HO cytotoxicity).
  • Both treatments increased the total antioxidant capacity (TAC) of DPC clones, suggesting a potential strategy to boost the number of transplanted cells that can effectively promote recovery in SCI by targeting the injury site.
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Aim: The underlying causes of failure or recurrence after ligation of the intersphincteric fistula tract are postulated to be refistulization, breakdown of the closure wound in the intersphincteric plane and faecal contents entering the internal opening, thereby causing recurrent infection. The aim of this study is to demonstrate the outcomes of subtotal fistulectomy with sliding anoderm flaps to prevent refistulization.

Method: This retrospective study used prospectively collected data.

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  • A study investigated a surgical alternative to lateral internal sphincterotomy for chronic anal fissures, focusing on the combined technique of fissurectomy, vertical non-full thickness midline sphincterotomy (VNMS), and mucosal advancement flap (MAF) to reduce incontinence risks.
  • The analysis included 46 patients who had not improved with topical treatments; results showed a 96% healing rate and no postoperative complications over a median follow-up of 27 months.
  • Fecal incontinence was not observed, and significant reductions in anal resting and squeeze pressures were recorded three months after surgery, indicating the procedure’s effectiveness while maintaining continence.
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  • IgA pemphigus is an autoimmune disease characterized by the presence of IgA autoantibodies targeting keratinocyte cell surfaces, resulting in skin and, rarely, oral mucosal lesions.
  • A 31-year-old woman exhibited skin erythema, pustules, and erosions in her mouth, with histopathology confirming acantholysis and neutrophil infiltration.
  • While typical cases of IgA pemphigus have limited oral involvement, this case highlights the presence of oral lesions as a potential indicator of anti-desmoglein 3 IgA, suggesting a rare subtype of the disease.
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  • Pyogenic myositis is a bacterial infection of skeletal muscle, commonly caused by Staphylococcus aureus, but can also occur in immunocompromised patients, particularly in tropical regions.
  • An 82-year-old Japanese man with type 2 diabetes experienced severe pain and swelling in his chest, leading to a diagnosis of pectoralis major pyomyositis caused by Morganella morganii after various tests ruled out other conditions.
  • The patient underwent surgical debridement and had a successful recovery, highlighting the need for prompt intervention as antibiotics alone may not be sufficient to treat this infection.
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Objectives: This study evaluates the safety and efficacy of laparoscopic ventral rectopexy (LVR) in nonagenarian patients with external rectal prolapse (ERP) compared to Delorme's procedure.

Methods: We conducted a retrospective analysis of prospectively collected data, including nonagenarian patients who underwent either LVR or Delorme's procedure, comparing outcomes such as morbidity, length of hospital stay (LOS), and recurrence rates.

Results: Between September 2009 and August 2023, 22 patients (median age 91, range 90-94 years) underwent LVR, while 12 patients (median age 91, range 90-96 years) received Delorme's procedure.

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This Policy Review sourced opinions from experts in cancer care across low-income and middle-income countries (LMICs) to build consensus around high-priority measures of care quality. A comprehensive list of quality indicators in medical, radiation, and surgical oncology was identified from systematic literature reviews. A modified Delphi study consisting of three 90-min workshops and two international electronic surveys integrating a global range of key clinical, policy, and research leaders was used to derive consensus on cancer quality indicators that would be both feasible to collect and were high priority for cancer care systems in LMICs.

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Unlabelled: WHAT IS KNOWN ON THE SUBJECT?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention-deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population. There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems.

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Objective: To analyze the relationship between hospitalization and the occurrence of delirium in older adults with physical frailty.

Method: Cross-sectional study carried out in a public hospital in southern Brazil. Hospitalized older adults aged ≥ 60 years participated.

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Background: Aluminum potassium sulfate and tannic acid (ALTA) is an effective sclerosing agent for the treatment of internal hemorrhoids. ALTA therapy with rectal mucopexy (AM) is a new approach for treating hemorrhoidal prolapse. This study investigated the midterm outcomes of AM surgery in patients with hemorrhoids.

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Candida osteomyelitis is a manifestation of invasive candidiasis. The common sites of infection are the vertebra, sternum, and femur, whereas infection of the rib cartilage is very rare. In the present case, candida costochondritis developed after traumatic small-bowel perforation.

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Objectives: To evaluate the prevalence of post-operative complications and quality of life (QoL) related to sentinel lymph node (SLN) biopsy vs systematic lymphadenectomy in endometrial cancer.

Methods: A prospective cohort included women with early-stage endometrial carcinoma who underwent lymph node staging, grouped as follows: SLN group (sentinel lymph node only) and SLN+LND group (sentinel lymph node biopsy with addition of systematic lymphadenectomy). The patients had at least 12 months of follow-up, and QoL was assessed by European Organization for Research and Treatment of Cervical Cancer Quality of Life Questionnaire 30 (EORTC-QLQ-C30) and EORTC-QLQ-Cx24.

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Carcinoid syndrome is caused by the release of serotonin and other substances, which commonly occurs due to liver metastasis of neuroendocrine tumors. It rarely occurs due to liver metastasis of neuroendocrine carcinoma. We report the case of a patient with liver metastasis of neuroendocrine carcinoma who suffered from acute abdominal pain and diarrhea triggered by hemodialysis.

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Electric bidet toilets are automatic devices that deliver water jets to clean the anus. Although the use of bidets to clean the anus after defecation contributes to hand hygiene and local comfort, excessive use may cause anal pruritus and incontinence. However, no cases of anorectal aphtoid ulcers caused by bidet use have yet been reported in literature.

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Purpose: This study aimed to compare the reduction in rectocele size after laparoscopic ventral rectopexy (LVR) with that after transanal repair (TAR).

Methods: Forty-six patients with rectocele who underwent LVR and 45 patients with rectocele who received TAR between February 2012 and December 2022 were included. This was a retrospective analysis of prospectively collected data.

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The patient was a 42-year-old woman. After 4 courses of capecitabine therapy for right chest wall recurrence of breast cancer, ER(+, 10-15%), PgR(-), HER2(-), she underwent pleurodesis using OK-432 for increased right pleural effusion. On the 12th day after pleurodesis diffuse infiltrative shadows in the right lung, and frosted shadows in both lungs, were observed, and she was diagnosed with drug-induced lung injury.

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Purpose: This study aimed to investigate the influence of erect position on anorectal manometry in patients with rectoanal intussusception (RAI).

Methods: This was a single center prospective observational study. Eighty female patients with fecal incontinence (FI) who underwent defecography between 1st January 2016 and 30th April 2022 were included.

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Purpose: This study was performed to assess the long-term annual functional outcomes and quality of life (QOL) after transanal rectocele repair.

Methods: We evaluated retrospectively collected data from patients who underwent transanal repair for symptomatic rectocele between February 2012 and December 2018. The Constipation Scoring System (CSS), the Fecal Incontinence Severity Index (FISI), and several QOL questionnaires (e.

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Importance: Many randomized clinical trials (RCTs) led by high-income countries (HICs) now enroll patients from lower middle-income countries (LMICs) and upper middle-income countries (UMICs). Although enrolling diverse populations promotes research collaborations, there are issues regarding which countries participate in RCTs and how this participation may contribute to global research.

Objective: To describe which UMICs and LMICs participate in RCTs led by HICs.

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