1,230 results match your criteria: "Citizens Hospital[Affiliation]"

Background: Fluoropyrimidine remains the key agent of adjuvant chemotherapy for stage III colorectal cancer (CRC). Western studies have shown that female sex is a favorable prognostic factor after surgery, but it is also a risk factor for adverse events (AEs) during adjuvant chemotherapy with fluoropyrimidine. However, little is known about whether sex differences in treatment outcomes exist in this setting in the Asian population.

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Purpose: To determine the clinical outcomes of endoscopic submucosal dissection (ESD) for colorectal tumors in older patients and predictors of mortality.

Methods: We retrospectively evaluated 207 lesions in 195 consecutive older patients aged ≥ 75 years who underwent ESD for colorectal tumors between January 2007 and December 2018. Outcomes of ESD were evaluated, and the prognosis was assessed in terms of both curability and the patient's baseline physical condition as determined by several indices.

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Background: Sepsis is a global health problem with high morbidity and mortality. Low- and middle-income countries have a higher incidence and poorer outcome with sepsis. Large epidemiological studies in sepsis using Sepsis-3 criteria, addressing the process of care and deriving predictors of mortality are scarce in India.

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Background: Open pancreaticoduodenectomy (OPD) is an essential surgical procedure for expert hepato-biliary-pancreatic (HBP) surgeons. However, there is no standard for how many surgeries must be performed by a surgeon in training before they are considered to have enough experience to ensure surgical safety.

Methods: Cumulative Sum (CUSUM) analysis was performed using the surgical data of OPDs performed during the training period of board-certified expert surgeons of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).

Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.

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The aging global population and the increasing use of antithrombotic agents have made spontaneous intramuscular hematomas (SIH) a growing concern. The association between the settings of SIH onset and clinical outcomes remains unclear. The aim of this study was to determine these associations.

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Chronic spontaneous urticaria (CSU) is a typical example of an intractable skin disease with no clear cause and significantly affects daily life of patients. Because CSU is a human-specific disease and lacks proper animal model, there are many questions regarding its pathophysiological dynamics. On the other hand, most clinical symptoms of urticaria are notable as dynamic appearance of skin eruptions called wheals.

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Article Synopsis
  • A study was conducted to evaluate the long-term effects of Cardiosphere-derived cell (CDC) infusion in patients with single ventricle heart disease, focusing on outcomes over an 8-year period.
  • Among 93 patients, those who received CDC infusion experienced a statistically significant reduction in late failure and adverse events compared to control patients, although overall survival rates at 8 years did not significantly differ.
  • The beneficial effects of CDC treatment on survival became more apparent by the 4-year mark, particularly for patients with heart failure, suggesting that CDC infusion may provide sustained clinical advantages over time.
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Idiopathic inflammatory myopathies, such as dermatomyositis, are implicated as possible risk factors for venous thromboembolism. We herein report the first known case of a 50-year-old woman who presented to our hospital with a fever, chest pain, and elevated creatine kinase levels and was ultimately diagnosed with pulmonary embolism and anti-OJ antibody-positive antisynthetase myopathy. Dermatomyositis may increase the risk of venous thromboembolism, including pulmonary embolism.

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Article Synopsis
  • - The study evaluated factors impacting the effectiveness of second-generation colon capsule endoscopy (CCE) in diagnosing colorectal issues, focusing on patient demographics, cleansing methods, and detection rates of polyps or tumors.
  • - Among 1,006 patients across 44 Japanese hospitals, findings revealed that younger age, male sex, and proper preparation significantly improved the success of CCE, with an overall detection rate of around 89-92% for larger colorectal tumors.
  • - CCE had a low retention rate and was generally well-accepted, with 63% of patients preferring CCE for future colonoscopies, reinforcing its safety and effectiveness when bowel preparation is adequate.
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Predictors of tolerability for postoperative adjuvant S1 plus docetaxel chemotherapy for gastric cancer: a multicenter retrospective study.

Gastric Cancer

January 2025

Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: Adjuvant docetaxel plus S1 (DS) chemotherapy after gastrectomy with D2 lymph node dissection is the standard treatment for stage III gastric cancer in Japan; however, some patients are unable to receive adequate drug administration because of the deterioration of their conditions. This study aimed to investigate the correlation between tolerability for postoperative adjuvant DS chemotherapy and prognosis, and the factors affecting tolerability.

Methods: This retrospective study involved patients with stage III gastric cancer who underwent curative resection between 2018 and 2021 from a multicenter database.

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Article Synopsis
  • - The study aimed to compare the effectiveness and safety of neoadjuvant chemohormonal therapy (NCHT) versus radical prostatectomy (RP) alone in patients with high-risk prostate cancer undergoing robot-assisted surgery.
  • - Data from 1,023 patients were analyzed, with results showing that those who received NCHT had a lower rate of biochemical recurrence (15.8% vs. 29.5%) and better pathology outcomes compared to the RP-only group.
  • - The findings indicate that NCHT could be a beneficial pre-surgery treatment for high-risk prostate cancer, improving outcomes without significant safety concerns, although some adverse events were noted.
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Background: In early-stage endometrial cancer (EC), the treatment of aggressive histological subtypes (endometrioid carcinoma grade 3, serous carcinoma, clear-cell carcinoma, undifferentiated carcinoma, mixed carcinoma, and carcinosarcoma) is controversial. We aimed to investigate the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IC and stage IIC EC according to the 2023 classification.

Methods: We retrospectively identified patients with FIGO 2023 stage IC, IIC-intermediate risk (IIC-I), and IIC-high risk (IIC-H) EC who underwent adjuvant therapy or observation after surgery at eight medical institutions from 2004 to 2023.

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Efficacy and safety of the contralateral approach to vascular lesions in the vertebral artery: patient series.

J Neurosurg Case Lessons

November 2024

Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background: Endovascular treatment is preferred over microsurgical clipping for intracranial aneurysms in the posterior circulation. However, access to lesions, particularly those in the regions of the vertebral artery (VA) and the posterior inferior cerebellar artery (PICA), is technically challenging in terms of the vessel diameter of the ipsilateral VA or the branching angle of the PICA.

Observations: Nine cases of intracranial aneurysms in the region of the PICA, which were endovascularly treated with an approach beyond the vertebrobasilar junction (VBJ) from the contralateral VA in the last 4 years, are described herein.

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Early diagnosis of nonconvulsive status epilepticus due to lithium intoxication using 6-channel electroencephalography.

CJEM

December 2024

Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan.

Introduction: Nonconvulsive status epilepticus is a severe complication of lithium intoxication that requires prompt diagnosis and treatment. While conventional electroencephalography (EEG) remains the gold standard for diagnosis for nonconvulsive status epilepticus, its implementation in emergency settings can be challenging and time-consuming. We present a case in which simplified EEG with six electrodes enabled rapid detection and monitoring of nonconvulsive status epilepticus in lithium intoxication in the emergency setting.

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Prognosis of chronic spontaneous urticaria with an inadequate response to omalizumab.

Int J Dermatol

November 2024

Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Article Synopsis
  • Chronic spontaneous urticaria (CSU) shows a good response to omalizumab (OMA), but patients who don't respond well need a closer look at their long-term prognosis and treatment options.
  • A study analyzed 48 patients who received three doses of OMA and tracked their progress over 12 months, finding that 28 had a good prognosis, while 20 had a less favorable outcome.
  • Key factors linked to better outcomes included shorter CSU duration, presence of angioedema, low IgE levels pre-treatment, increased eosinophils after treatment, and higher urticaria control test scores; using immunosuppressants also predicted a better prognosis, while corticosteroids had a negative impact.
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Gastro-tracheal fistula following esophageal cancer surgery through the retrosternal route: a case report.

Surg Case Rep

November 2024

Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.

Background: Gastro-tracheal fistula is a rare but serious complication after esophageal surgery, often requiring long-term treatment and invasive procedures. Gastro-tracheal fistula usually occurs through the posterior mediastinal route and rarely through the retrosternal route. No previous reports have described gastro-tracheal fistula after retrosternal route reconstruction was cured by conservative treatment.

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Background: We conducted a randomize phase II study to evaluate the efficacy and safety of topoisomerase II inhibitor amrubicin plus topoisomerase I inhibitor irinotecan (AI) compared with cisplatin plus irinotecan (PI) as first-line therapy in patients with extensive-disease (ED) small-cell lung cancer (SCLC).

Patients And Methods: Chemo-naïve patients with pathologically proven ED-SCLC (including limited disease (LD) SCLC with malignant effusion) were enrolled. Patients were randomized 1:1 to receive either AI (amrubicin 90mg/m on day 1 and irinotecan 50mg/m on days 1 and 8 of a 21-day cycle) or PI (cisplatin 60mg/m on day 1 and irinotecan 60mg/m on days 1, 8 and 15 of a 28-day cycle).

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Article Synopsis
  • Intracranial pseudoaneurysm is a rare condition that can change shape, making treatment decisions complex based on each unique situation.
  • A 43-year-old woman suffered a cardiopulmonary arrest due to a subarachnoid hemorrhage, revealing a dynamic middle cerebral artery-lenticulostriate artery bifurcation aneurysm suspected to be a pseudoaneurysm.
  • Initial treatment involved coil embolization, which required follow-up procedures due to recanalization, but ultimately led to successful obliteration and rehabilitation of her symptoms.
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Sarcopenia's Impact Defined by Grip Strength and Muscle Mass on Post-hepatectomy Outcomes: A Multicenter Analysis.

In Vivo

October 2024

Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Article Synopsis
  • Sarcopenia, characterized by decreased grip strength and skeletal muscle mass, is linked to worse outcomes in patients undergoing liver surgery for hepatocellular carcinoma (HCC).
  • A study analyzed 253 patients, finding that 14.2% had sarcopenia, and this group faced higher complications, particularly older patients with comorbid conditions.
  • The findings suggest that sarcopenia is an independent risk factor for severe postoperative issues, highlighting the need for assessment before surgery.
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Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement with Evolut FX up until October 2023.

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Article Synopsis
  • CRUSE® is an app designed for people with chronic spontaneous urticaria (CSU) to track their symptoms using visual analogue scales (VASs), aiming to assess the app's effectiveness in measuring disease activity.
  • A study analyzed three VASs related to CSU impact on daily life, including one specifically for the severity of urticaria, one for productivity, and a general health measure (EQ-5D), using data from nearly 6,000 patients over many days.
  • The results showed that the CRUSE® app's VASs demonstrate strong validity and reliability, with the "VAS urticaria" being most effective in capturing symptom changes, while the minimal important difference (MID) values indicated meaningful changes
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Clinical Significance of Prior Ramucirumab Use on the Effectiveness of Nivolumab as the Third-Line Regimen in Gastric Cancer: A Multicenter Retrospective Study.

Drugs Real World Outcomes

December 2024

Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Article Synopsis
  • Researchers studied the effects of ramucirumab (RAM) before nivolumab treatment in patients with advanced gastric cancer to see if it improved immune cell function and survival rates.
  • The study analyzed 52 patients' outcomes, comparing those who received RAM with those who did not, finding that the RAM group had significantly longer overall survival (8.5 months vs 6.9 months).
  • The results indicated that RAM usage before nivolumab may enhance survival, particularly in patients without peritoneal metastasis, who showed even better outcomes (23.8 months vs 7.7 months).
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Article Synopsis
  • Gastric conduit obstruction (GCO) can occur after esophagectomy, and this case highlights a rare instance where it was successfully repaired using laparoscopic revision surgery.
  • A 66-year-old man experienced difficulty in fluid passage 14 months post-surgery due to a twisted and deviated gastric conduit, necessitating revision surgery.
  • The case underscores the importance of optimal fixation methods during the initial surgery to prevent GCO and indicates that intraoperative endoscopy can effectively assist in diagnosing and resolving obstructions.
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Predicting elevated natriuretic peptide in chest radiography: emerging utilization gap for artificial intelligence.

Eur Heart J Imaging Methods Pract

January 2024

Department of Cardiology, Hiroshima City Asa Hospital, 1-2-1, Kameyamaminami, Asakita-ku, Hiroshima 7310293, Japan.

Article Synopsis
  • A study evaluated an AI model's ability to predict elevated brain natriuretic peptide (BNP) levels from chest radiograms, focusing on its impact on healthcare professionals' diagnostic accuracy.
  • The AI model was developed using data from over 8,000 chest images and demonstrated high performance metrics, including an accuracy of 85.5% and a receiver-operating-characteristics area-under-curve score of 0.929.
  • Results showed that the AI assistance significantly improved diagnostic accuracy for both experienced and early-career healthcare professionals, with early-career professionals outperforming veterans when using the AI tool.
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