Publications by authors named "Yuga Komaki"
Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.
Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).
Results: A total of 6575 patients with CDB were included.
Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower GI bleeding (ALGIB).
Methods: We analyzed 8956 patients with ALGIB in the Colonic Diverticular Bleeding Leaders Update Evidence From Multicenter Japanese Study (CODE BLUE-J) study and categorized them into 4 groups based on the BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.
Background And Aims: Microscopic colitis has been increasingly recognized as a cause of chronic diarrhoea. We aimed to characterize the role of disease-related factors and treatments on the clinical outcomes of microscopic colitis.
Methods: We retrospectively reviewed the medical records of patients with microscopic colitis who were treated at the University of Chicago and Oregon Health & Science University between August 2010 and May 2016.
Article Synopsis
- The study examined the link between blood group O and the likelihood of rebleeding in patients with acute lower gastrointestinal bleeding (ALGIB).
- Out of 2336 patients analyzed, those with blood group O had higher rebleeding rates within 30 days (17.9%) and 1 year (21.9%) compared to non-O patients.
- Blood group O was found to be an independent risk factor for rebleeding, while rates of thrombosis and mortality were similar between groups.
Article Synopsis
- The study analyzed 8,254 cases of patients with acute lower gastrointestinal bleeding to find key factors that predict mortality and create a reliable prediction tool.
- Researchers established the CACHEXIA score, which uses factors present at admission and management during hospitalization to assess the risk of death within 30 days and 1 year.
- The CACHEXIA score demonstrated high accuracy (ROC-AUC 0.93 for 30 days; C-index 0.88 for 1 year) with significant differentiation of mortality risk, indicating that patients with high scores need continuous monitoring after discharge.
Article Synopsis
- A study analyzed data from 10,342 patients with acute lower gastrointestinal bleeding (ALGIB) to better understand surgical rates, procedures, and outcomes.
- Surgery was performed in only 1.3% of patients, with common indications being diverticular bleeding, colorectal cancer, and small bowel bleeding, and the overall mortality rate was 1.5% for those who underwent surgery.
- The findings suggest that identifying the source of bleeding and using endoscopic techniques may lower the need for surgery and enhance treatment for ALGIB.
Exposure to a novel environment is psychologically and physically stressful for humans and animals. The response has been reported to involve enhanced sympathetic nervous system activity, but changes in nutrient levels under stress are not fully understood. As a form of exposure to a novel environment, repeated cage exchange (CE, four times at 2-h intervals for 8 h from 08:00 h) during the light phase with no restraint on movement was applied to A/J mice, a strain particularly prone to stress.
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- This study compared the effects of early versus delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB) after their bleeding was controlled.
- Researchers analyzed data from 5,910 patients across Japan, dividing them into early (feeding within 1 day) and delayed (feeding after 2-3 days) groups.
- Results showed no significant differences in rebleeding rates or need for further treatments between the groups, but the early feeding group had a shorter hospital stay, suggesting it is a safe and beneficial practice.
Article Synopsis
- A study analyzed the impact of weekend admissions on outcomes for patients with acute lower gastrointestinal bleeding in 49 Japanese hospitals from 2010 to 2019.
- The findings showed no significant difference in mortality rates between weekend and weekday admissions, although weekend admissions resulted in a higher need for blood transfusions.
- Additionally, weekend admissions led to delays in early colonoscopy and an increase in urgent CT scans, but overall mortality and other outcomes remained unaffected.
Article Synopsis
- A predictive model called the LONG-HOSP score was developed to assess the risk of prolonged hospital stays for patients admitted with acute lower gastrointestinal bleeding (ALGIB), based on their baseline characteristics.
- The study analyzed data from over 8,500 patients across 49 hospitals to create and validate this model, which includes factors such as age, body mass index, and various lab results.
- Findings revealed that certain conditions and treatments during hospitalization, like colitis diagnosis and early colonoscopy, significantly impacted the length of stay, with early interventions helping to reduce it.
Article Synopsis
- This study compares the effectiveness of short vs. long attachment caps in colonoscopy for identifying causes of acute hematochezia, specifically looking at recent hemorrhage.
- Using data from over 6,400 patients, researchers found that long cap users had significantly higher rates of diagnosing colonic diverticular bleeding and identifying active bleeding, compared to short cap users.
- The conclusion suggests that long cap-assisted colonoscopy is more effective for diagnosing acute hematochezia and recognizing bleeding compared to short caps.
Background/aim: Smoking has been reported to be a risk factor for a variety of diseases. In Japan, the Brief Job Stress Questionnaire (BJSQ) has been administered by the Ministry of Health, Labour and Welfare since December 2015, but few reports have focused on its relationship with smoking. We investigated the current situation of smokers among staff of Kagoshima University who underwent a medical check-up.
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- A study analyzed long-term outcomes of 5048 patients hospitalized for acute lower gastrointestinal bleeding (ALGIB) in Japan to understand risks of recurrence after discharge.
- Findings revealed that 25.8% of patients experienced rebleeding within an average follow-up of 31 months, with significant mortality risks increasing for those with out-of-hospital rebleeding episodes.
- Key risk factors for rebleeding included shock index, blood transfusion, in-hospital rebleeding, colonic diverticular bleeding, and thienopyridine use, while endoscopic hemostasis was found to reduce rebleeding risk.
Article Synopsis
- - The study compared the effectiveness of two ligation therapies, endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), in treating colonic diverticular bleeding (CDB) using data from 518 patients within a multicenter study.
- - Findings revealed no significant differences in outcomes like initial hemostasis, recurrent bleeding within 30 days, mortality, or need for additional interventions between the two treatment groups.
- - Sigmoid colon involvement and a history of acute lower gastrointestinal bleeding (ALGIB) were identified as significant risk factors for long-term recurrent bleeding, emphasizing the need for careful follow-up after ligation therapy.
Article Synopsis
- The study investigates angioectasia as a cause of acute hematochezia and identifies significant risk factors such as chronic kidney disease, liver disease, female gender, lower body mass index, and anticoagulant use.
- Among the 10,342 patients analyzed, only 1.2% were diagnosed with angioectasia, with this group experiencing a higher need for blood transfusions and a notable incidence of rebleeding.
- Coagulation therapy was found to significantly reduce rebleeding risk compared to conservative management, indicating its effectiveness in treating patients with angioectasia-related hematochezia.
Article Synopsis
- The study aimed to find the best timing for colonoscopy in patients with acute lower GI bleeding and to identify factors that could help them.
- Researchers analyzed data from over 6,200 patients who had colonoscopy within 120 hours of bleeding, comparing outcomes based on early (≤24 hours), elective (24-48 hours), and late (48-120 hours) procedures.
- Early colonoscopy led to better identification of recent bleeding and shorter hospital stays but also had a higher rebleeding rate, without affecting mortality or the need for additional interventions; it was especially beneficial for patients with a higher shock index or poor performance status.
[Stenotic ischemic enteritis secondary to intraperitoneal band infiltration: a case report].
Nihon Shokakibyo Gakkai Zasshi
June 2022
A 55-year-old man presented with vomiting and upper abdominal pain. Two months later, computed tomography revealed jejunal wall thickening and contrast enhancement. Double-balloon endoscopy revealed severe jejunal stenosis and mucosal prolapse.
View Article and Find Full Text PDFBackground: Capsule endoscopy has been widely used to investigate obscure gastrointestinal bleeding (OGIB) in the small intestine since its approval in 2001. However, the clinical features of OGIB remain unclear.
Aim: We retrospectively examined the clinical features and risk factors of OGIB in patients who underwent capsule endoscopy in our hospital.
Background: Direct and indirect clipping treatments are used worldwide to treat colonic diverticular bleeding (CDB), but their effectiveness has not been examined in multicenter studies with more than 100 cases.
Objective: We sought to determine the short- and long-term effectiveness of direct versus indirect clipping for CDB in a nationwide cohort.
Methods: We studied 1041 patients with CDB who underwent direct clipping (n = 360) or indirect clipping (n = 681) at 49 hospitals across Japan (CODE BLUE-J Study).
Background And Aims: Treatment strategies for colonic diverticular bleeding (CDB) based on stigmata of recent hemorrhage (SRH) remain unstandardized, and no large studies have evaluated their effectiveness. We sought to identify the best strategy among combinations of SRH identification and endoscopic treatment strategies.
Methods: We retrospectively analyzed 5823 CDB patients who underwent colonoscopy at 49 hospitals throughout Japan (CODE-BLUE J-Study).
Objectives: A histopathological tumor thickness of ≥1000 μm has been reported as one of many risk factors for recurrent lymph node metastasis in superficial pharyngeal cancer (SPC). However, methods for assessing this risk factor preoperatively have not yet been established. Hence, the current study aimed to evaluate the efficacy of endoscopic ultrasonography (EUS) in measuring tumor thickness preoperatively in patients with SPC.
View Article and Find Full Text PDFOutcomes of acute lower gastrointestinal bleeding have not been compared according to hospital capacity. We aimed to perform a propensity score-matched cohort study with path and mediation analyses for acute hematochezia patients. Hospitals were divided into high- versus low-volume hospitals for emergency medical services.
View Article and Find Full Text PDFIntroduction: The bleeding source of hematochezia is unknown without performing colonoscopy. We sought to identify whether colonoscopy is a risk-stratifying tool to identify etiology and predict outcomes and whether presenting symptoms can differentiate the etiologies in patients with hematochezia.
Methods: This multicenter retrospective cohort study conducted at 49 hospitals across Japan analyzed 10,342 patients admitted for outpatient-onset acute hematochezia.
Background & Aims: Serrated polyposis syndrome (SPS) is characterized by development of numerous serrated lesions throughout the colorectum and increased risk of colorectal cancer (CRC). However, SPS has been an underrecognized CRC predisposition syndrome, and the true risk of CRC in SPS, both overall and in surveillance, is not known. The aim of this systematic review and meta-analysis is to describe the risk of CRC in patients with SPS.
View Article and Find Full Text PDFPatients with inactive acetaldehyde dehydrogenase 2 (ALDH2) are at high risk for esophageal squamous cell carcinoma (ESCC) and hypopharyngeal squamous cell carcinoma (HPSCC). The acetaldehyde breath test (ABT) may demonstrate ALDH2 gene polymorphisms. We evaluated the usefulness of the ABT in patients with ESCC and HPSCC.
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