Publications by authors named "Yusuke Saigusa"
Objectives: New scores were developed to identify at-risk metabolic dysfunction-associated steatohepatitis (MASH) using multiparametric MRI (mpMRI).
Materials And Methods: A prospective study was conducted on 176 patients with suspected or diagnosed metabolic dysfunction-associated steatotic liver disease (MASLD) paired with an MR scan, vibration-controlled transient elastography (VCTE), and liver biopsy. Liver stiffness measurement (LSM) using magnetic resonance elastography (MRE), proton density fat fraction (PDFF), and mpMRI-based corrected T1 (cT1) were combined to develop a one-step strategy, named MPcT (MRE + PDFF + cT1, combined score), and a two-step strategy-MRE-based LSM followed by PDFF with cT1 (M-PcT, paired score) for diagnosing at-risk MASH.
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- Cervical cancer screening rates in Japan are low, making prenatal visits an important opportunity for women to undergo cervical cytology tests during pregnancy, according to this study.
- The study analyzed data from 2,725 participants, revealing that certain factors such as smoking, younger age, lower education levels, and specific sampling methods were linked to higher rates of abnormal cervical results (ASC-US).
- Results showed that nearly 40% of participants with abnormal results thought they had “no abnormalities,” highlighting the need for better patient education and follow-up for those with detected issues.
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- Telemedicine in Japan has grown due to COVID-19 deregulation, but its current use is mainly by general practitioners and is still unclear.
- This study examines telemedicine's role in sublingual immunotherapy (SLIT) for allergies, comparing patients who used a mix of telemedicine and in-person visits to those who only had in-person visits.
- Results showed no significant differences in dropout rates, side effects, or treatment effectiveness, although telemedicine patients had higher copayment costs; further research is needed to clarify telemedicine's status in Japanese healthcare.
Background: The occurrence of hypotension after induction of general anaesthesia is common in geriatric patients, and should be prevented to minimise perioperative complications. Compared with propofol, remimazolam potentially has a lower incidence of hypotension. This study aimed to compare the incidence of hypotension after general anaesthesia induction with remimazolam or propofol in geriatric patients.
View Article and Find Full Text PDFBackground: Anti-SS-A/Ro antibody (anti-SSA), the diagnostic marker of Sjögren's syndrome (SS), is often detected in systemic sclerosis (SSc). Some patients are diagnosed with SSc/SS overlap syndromes, while there are anti-SSA-positive SSc cases without SS. In this study, we investigated the clinical characteristics of SSc with anti-SSA and clarified the clinical impact of this antibody in SSc.
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- The study examined whether chronic adaptive servo-ventilation (ASV) therapy affects mortality and urgent rehospitalization rates in heart failure patients.
- Conducted on 845 hospitalized heart failure patients in Japan, 110 were treated with ASV, and a year-long follow-up tracked 272 patients for primary outcomes.
- Results showed a shorter time to rehospitalization in the ASV group compared to the non-ASV group, but there was no significant difference in all-cause mortality between both groups.
Aim: Peripheral artery disease (PAD) severely impairs patient prognosis and quality of life (QOL). Although lipoprotein apheresis (LA) has been applied to patients with PAD and elevated serum atherogenic lipoproteins, we hypothesized that LA can be effective for treating PAD even in patients with controlled serum lipoproteins through pleiotropic anti-atherosclerotic effects beyond lipoprotein removal. This study aimed to evaluate the efficacy of LA in patients with treatment-resistant PAD and controlled serum lipoproteins focusing on QOL.
View Article and Find Full Text PDFIntroduction: In Japan, telemedicine has gradually expanded due to deregulation in response to the COVID-19 pandemic. However, its current status remains unclear, as it is primarily provided by general practitioners. Meanwhile, telemedicine has begun to be utilized for low-dose estrogen-progestin (LEP) prescriptions for dysmenorrhea.
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- A study examined the effectiveness of high-dose methotrexate (HD-MTX) compared to intrathecal methotrexate (IT-MTX) for preventing CNS relapses in high-risk diffuse large B-cell lymphoma (DLBCL) patients.
- Out of 132 patients analyzed, the incidence of CNS relapse was similar between the HD-MTX (6.1%) and IT-MTX (14.7%) groups, with cumulative rates at 3 years being 3.9% and 6.1% respectively.
- The results indicated that HD-MTX did not show superior efficacy over IT-MTX in preventing CNS relapse in these patients.
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- - The study aims to identify risk factors for complications during and after complete removal of upper urinary stones using flexible ureterorenoscopy in patients with ipsilateral stones.
- - Researchers analyzed data from 111 patients and found that the overall complication rate was 29.7%, with only minor issues reported and no severe complications observed; key predictors of complications included ureteral stone volume and being female.
- - The findings suggest that by recognizing patients at lower risk based on these factors, healthcare providers can improve outcomes while effectively managing urinary stones, potentially reducing recurrence rates without heightening complication risks.
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- * In a study of 51 patients, those who died within 12 weeks had significantly higher serum HO-1 levels compared to survivors, highlighting its role in mortality prediction.
- * The study suggests that measuring serum HO-1 could help assess the prognosis and mortality risk for patients experiencing acute exacerbations of ILDs.
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- * The objective was to assess if a learning program sharing treatment protocols for low-evidence biomarkers could align MTB recommendations and evaluate the effectiveness of an AI-based annotation system.
- * The study involved 47 participants and 50 simulated cases, comparing treatment recommendation concordance before and after the learning program, with the aim to achieve high agreement levels post-learning.
This study aimed to identify immune mediators, including cytokines, chemokines, and growth factors, in the plasma for predicting treatment efficacy and immune-related adverse events (irAEs) in advanced urothelial carcinoma (aUC) treated with immune checkpoint inhibitors (ICIs). We enrolled 57 patients with aUC who were treated with the anti-programmed cell death protein 1 (PD-1) antibody pembrolizumab after the failure of platinum-based chemotherapy between February 2018 and December 2020. Plasma levels of 73 soluble immune mediators were measured before and 6 weeks after initiating pembrolizumab therapy.
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- The study aimed to test whether adjuvant chemotherapy for stage III colon cancer could be effectively shortened from the conventional 6 months to 3 months using the SOX regimen (S-1 and oxaliplatin).
- In a randomized phase II trial, patients received either 3 months or 6 months of SOX treatment, with the primary goal of measuring 3-year disease-free survival (DFS).
- Results showed that the 3-year DFS rates were similar for both groups (75% for 6 months and 76.9% for 3 months), indicating that shortening the treatment did not significantly improve outcomes, and the primary endpoint was not met.
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- Acute exacerbation (AE) of interstitial pneumonia (IP) has a poor prognosis due to severe lung damage combined with existing fibrosis.
- A study compared clinical data from 66 patients with AE of idiopathic interstitial pneumonias (IIPs) and 19 patients with collagen vascular disease-associated interstitial pneumonia (CVD-IP), focusing on factors like age, health status (Charlson Comorbidity Index score), blood biomarkers, treatment, and mortality.
- Findings revealed that the Charlson Comorbidity Index score and serum lactate dehydrogenase levels were significant predictors of 3-month mortality, indicating that these metrics may be more crucial indicators of patient outcomes than the specific type of interstitial pneumonia.
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- Non-contact continuous respiratory rate monitoring is being developed for early patient deterioration detection, but no gold standard has yet been established for accuracy comparison.
- In a study, patient respiratory rates were simultaneously measured using a microwave Doppler sensor and three other methods, with data analyzed for accuracy based on the established capnography standard.
- Results showed that while the microwave Doppler sensor had small biases in measurements, its clinical decision-making effectiveness was high, similar to the other devices tested.
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- - The study investigates the connection between resistance to osimertinib (an EGFR-TKI) and PD-L1 expression in patients with EGFR-mutated non-small cell lung carcinoma (NSCLC).
- - Analyzing 64 patients, researchers found that those with a PD-L1 tumor proportion score (TPS) ≥20% had a median progression-free survival (PFS) of 9.1 months, compared to 28.1 months for those with TPS <20%.
- - Results suggest that a higher PD-L1 TPS may indicate early resistance to osimertinib, highlighting the importance of PD-L1 status in managing treatment for EGFR-mutated NSCLC.
Background: Post-pyloric enteral feeding reduces respiratory complications and shortens the duration of mechanical ventilation. Blind placement of post-pyloric enteral feeding tubes (EFT) in patients with critical illnesses is often the first-line method because endoscopy or fluoroscopy cannot be easily performed at bedside; however, difficult placements regularly occur. We reported an association between the stomach position caudal to spinal level L1-L2, evaluated by abdominal radiographs after placement, and difficult placement; however, this method could not indicate difficulty before EFT placement.
View Article and Find Full Text PDFBackground: Clinical trials enroll patients with active fibrotic nonalcoholic steatohepatitis (NASH) (nonalcoholic fatty liver disease [NAFLD] activity score ≥ 4) and significant fibrosis (F ≥ 2); however, screening failure rates are high following biopsy. We developed new scores to identify active fibrotic NASH using FibroScan and magnetic resonance imaging (MRI).
Methods: We undertook prospective primary (n = 176), retrospective validation (n = 169), and University of California San Diego (UCSD; n = 234) studies of liver biopsy-proven NAFLD.
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- The study aimed to determine if indocyanine green fluorescence imaging (ICG-FI) could lower the rate of anastomotic leakage in patients undergoing minimally invasive rectal cancer surgery.
- Conducted across 41 hospitals in Japan, 850 patients were randomized into two groups: one receiving ICG-FI for blood flow evaluation and the other not receiving it, with outcomes measured for leakage rates.
- The results showed that the ICG+ group had a significantly lower anastomotic leakage rate (7.6%) compared to the ICG- group (11.8%), indicating that while ICG-FI did help reduce leakage, it was not superior to traditional methods.
Objectives: Severe submucosal fibrosis is a crucial technical difficulty encountered during endoscopic submucosal dissection (ESD) in patients with ulcerative colitis (UC). We aimed to identify predictors of severe submucosal fibrosis in patients with UC.
Methods: We retrospectively included 55 tumors resected using ESD from 48 consecutive patients with UC.
Background: Despite the widespread availability of medication choices for metastatic castration-resistant prostate cancer (mCRPC), biomarkers to predict the efficacy of each mCRPC treatment have not yet been established. This study developed a prognostic nomogram and a calculator to predict the prognosis of patients with mCRPC who received abiraterone acetate (ABI) and/or enzalutamide (ENZ).
Methods: In total, 568 patients with mCRPC who underwent ABI and/or ENZ between 2012 and 2017 were enrolled.
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- The study investigates the effects of two forms of aripiprazole (oral and long-acting injectable) on the autonomic nervous system (ANS) in patients with schizophrenia.
- 122 patients participated, with 72 taking oral aripiprazole and 50 receiving the once-monthly injectable version, and heart rate variability was measured to evaluate ANS activity.
- Results indicated that oral aripiprazole led to lower sympathetic nervous activity compared to the injectable version, suggesting that AOM has fewer negative effects on ANS function.