Consensus statement on chronic pain treatment in cancer survivors.

In September 2023, the Japan Society of Pain Clinicians (JSPC) issued this consensus statement on chronic pain treatment in cancer survivors. With recent advances in the early diagnosis and treatment of cancer, its prognosis has improved, so prolonged pain in cancer survivors is considered to represent chronic pain and should be addressed. In this statement, we emphasize that not all cancer survivor pain is cancer pain.

[Laparoscopic Hiatal Hernia Repair].

Esophageal hiatal hernia is a condition in which the esophageal hiatus opens and the stomach escapes from the abdominal cavity into the mediastinum. The basic surgical procedures are 1) return of the prolapsed stomach into the abdominal cavity, 2) suture of the dilated esophageal hiatus, and 3) fundoplication and fixation of the stomach to prevent gastroesophageal reflux disease (GERD). The Japanese guidelines for the treatment of GERD recommend laparoscopic Toupet fundoplication as the standard procedure, which we also follow.

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study.

Background: The general medicine in-training examination (GM-ITE) assesses physicians' clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).

Methods: This multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023.

A Questionnaire Study of Leadership in General Medicine: General Physicians in Japan are Facing Challenges in Education and Research.

Purpose: General physicians are required to demonstrate diverse leadership skills depending on their environment. It is essential for them to understand the characteristics of the medical institutions to which they belong and put this understanding into practice. Leadership skills are acquired through experience and training, and their acquisition is a goal in various medical training programs.

Enhancing Clinical Reasoning Education: Implementing Case Conferences with Semantic Qualifiers and the Dual-Process Theory.

Clinical reasoning skills are crucial for physicians. In clinical reasoning conferences using real cases, medical students, residents, and senior residents can follow experts' clinical reasoning processes. However, supervisors may struggle to clearly articulate their clinical reasoning process.

Effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae.

Background: Anesthetic management of a patient with multiple giant bullae is generally difficult due to an increased risk of respiratory complications, and there is no consensus regarding safe extubation methods. We report a case of an effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae, in whom a double-lumen bronchial tube was being used during anesthesia.

Case Presentation: A 52-year-old man with multiple giant bullae underwent video-assisted pulmonary resections, while the ventilation was controlled via a double-lumen bronchial tube.

Successful Microsurgical Clipping under Extracorporeal Membrane Oxygenation Treatment for a Poor-Grade Subarachnoid Hemorrhage Patient with Severe Pulmonary Neurogenic Lung.

Hemorrhagic strokes are considered as contraindications of extracorporeal membrane oxygenation (ECMO) therapy because of anticoagulant administration and ECMO-associated coagulopathy. We present a rare case of successful microsurgical clipping under ECMO for a poor-grade subarachnoid hemorrhage (SAH) patient with severe neurogenic pulmonary edema (NPE). A 50-year-old man presenting with the sudden loss of consciousness was diagnosed with poor-grade SAH with severe NPE, and was intubated.

Facilitating Trust Calibration in Artificial Intelligence-Driven Diagnostic Decision Support Systems for Determining Physicians' Diagnostic Accuracy: Quasi-Experimental Study.

Background: Diagnostic errors are significant problems in medical care. Despite the usefulness of artificial intelligence (AI)-based diagnostic decision support systems, the overreliance of physicians on AI-generated diagnoses may lead to diagnostic errors.

Objective: We investigated the safe use of AI-based diagnostic decision support systems with trust calibration by adjusting trust levels to match the actual reliability of AI.

Incidence and risk factors for venous thromboembolism in gynecological cancer: the GOTIC-VTE trial.

Real-world data on venous thromboembolism (VTE) in Japanese patients with gynecological cancer are lacking. The GOTIC-VTE trial aimed to evaluate the frequency of VTE-associated events and risk factors at the time of cancer diagnosis and during 1-year follow-up. From July 2017 to February 2019, patients with endometrial, cervical, ovarian, tubal, or peritoneal cancer who underwent VTE screening within 2 months before registration, were enrolled.

Epstein-Barr Virus-Positive Diffuse Large B-cell Lymphoma Arising in Ulcerative Colitis: An Instructive Case Report and Literature Review.

Malignant lymphoma is a relatively rare complication in patients with ulcerative colitis (UC) and its etiology is unclear. We present a hard-to-diagnose case of Epstein-Barr virus-positive diffuse large B-cell lymphoma in an elderly patient with UC who was treated with the immunomodulator tacrolimus and herbal medicine including indigo naturalis. Because malignant lymphomas can mimic other inflammatory diseases macroscopically, diagnosis in such cases can be challenging.

Validation of the Japanese version of the scoliosis research society-30 questionnaire for adult patients with spinal deformity.

Background: The Scoliosis Research Society-30 (SRS-30) is a questionnaire that was originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprises two sections, with Section 1 containing 22 items related to the SRS-22r questionnaire and 1 item regarding self-image and Section 2 containing 7 items specifically related to postoperative status. The SRS-30 has been also found useful in evaluating spinal disorders or deformity in adults.

Adapting Artificial Intelligence Concepts to Enhance Clinical Decision-Making: A Hybrid Intelligence Framework.

Purpose: Artificial intelligence (AI) holds great potential for revolutionizing health care by providing clinicians with data-driven insights that support more accurate and efficient clinical decisions. However, applying AI in clinical settings is often challenging due to the complexity and vastness of medical information. This perspective article explores how AI development methodologies can be adapted to support clinicians in their decision-making processes, emphasizing the importance of a hybrid approach that combines AI capabilities with clinicians' expertise.

Self-compassion in patients undergoing haemodialysis: A qualitative study.

Background: Patients undergoing haemodialysis require long-term treatment and suffer from physical limitations and emotional distress due to restrictions in daily life, such as food and fluid restrictions, which can lead to self-criticism and depression. To address these issues, the concept of self-compassion, which is important for patients undergoing haemodialysis, has gained attention.

Objective: This study aimed to identify self-compassion in patients undergoing haemodialysis.