725 results match your criteria: "Hiroshima Citizens Hospital[Affiliation]"

: Although previous reports have shown that early anterior cruciate ligament (ACL) reconstruction is associated with an increased risk of stiffness, recommendations for delayed surgery are based on outdated literature. The advent of arthroscopic surgery and accelerated rehabilitation protocols warrants a reexamination of the optimal surgical timing. The purpose of this study was to investigate complications during early ACL reconstruction after injury in young athletes.

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Middle-Ear Salivary Gland Choristoma with Congenital, Single-Sided Hearing Loss.

Acta Med Okayama

August 2024

Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Middle-ear salivary gland choristoma (SGCh) is a rare, benign tumor that causes conductive hearing loss owing to middle-ear morphological abnormalities. Early diagnosis is challenging, and surgical resection is indispensable for a definitive diagnosis. We report the case of a 3-year-old boy diagnosed with middle-ear SGCh during the follow-up period for left-sided hearing loss discovered at newborn hearing screening (NHS).

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Article Synopsis
  • Failure to retrieve a distal filter-based embolic protection device (EPD) during carotid artery stenting can occur if the device gets trapped, requiring careful monitoring of the space between the stent and EPD.* -
  • The study tested different combinations of stents and EPDs to see how often they got stuck, with four physicians rating the force needed for entrapment on a 5-point scale.* -
  • The Casper stent-Spider FX EPD was found to be particularly difficult to disengage if trapped, highlighting the importance of understanding device features to avoid serious complications.*
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Article Synopsis
  • The study investigates the financial burden of metastatic breast cancer treatments in Japan, highlighting the growing incidence of the disease and its associated healthcare costs.
  • A web-based survey conducted at 51 hospitals involved 702 patients, revealing that nearly half were receiving high-cost treatments, with some patients facing expenses over 1,000,000 JPY per month.
  • Key findings indicated that the most expensive therapy, abemaciclib, increased patient costs significantly, emphasizing the need to assess total cost increases rather than just drug prices in evaluating treatment options.
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Suvorexant for Reduction of Delirium in Older Adults After Hospitalization: A Randomized Clinical Trial.

JAMA Netw Open

August 2024

MDS K.K. (Merck Sharp & Dohme LLC, a subsidiary of Merck & Co Inc), Tokyo Japan.

Importance: Delirium is common among older hospitalized adults. In addition to presenting immediate management issues, delirium can increase the long-term risk of dementia, institutionalization, and mortality. Delirium is associated with disrupted sleep, and prior studies suggest that some specific sleep-promoting agents may reduce delirium.

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Iron deficiency anemia is the most common cause of anemia in pregnancy. Therefore, iron administration is recommended for treatment. Iron deficiency anemia during pregnancy does not always result in microcytic anemia.

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Article Synopsis
  • The study by the Epilepsy Subcommittee of the Japanese Society of General Hospital Psychiatry aimed to identify challenges that psychiatrists face when treating epilepsy and transitioning patients from pediatric to adult care.
  • A survey was conducted with 1,980 psychiatrists, out of which 545 responded, revealing that a significant majority (89.2%) felt hesitant about treating epilepsy and managing the transition of patients.
  • Factors like years of experience, board certification in epilepsy, and workplace support from specialists were associated with reduced hesitancy and increased confidence in providing quality care for epilepsy patients.*
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Relapsed and/or refractory (R/R) primary central nervous system lymphoma (PCNSL) has a poor prognosis. A 57-year-old man diagnosed with PCNSL achieved a complete response by high-dose methotrexate-based chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT). The disease was not cured, so he was treated with the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel after the third relapse.

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Wnt/β-Catenin-Activated Nonpilomatrical Carcinoma of the Skin: A Case Series.

Mod Pathol

November 2024

Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; "Biologie des infections à polyomavirus" Team, UMR INRA ISP 1282, Université de Tours, Tours, France.

Article Synopsis
  • The study investigates 16 primary cutaneous carcinomas with mutations in genes that activate the Wnt/β-catenin pathway, noting that these tumors lack matrical differentiation, which is typically associated with such mutations.
  • The tumors predominantly affected elderly patients, with a median age of 80, and were mainly located on the head, neck, and upper limbs, leading to metastatic cases in some patients.
  • Key findings include poor differentiation in tumor structure, distinct immunohistochemical profiles, and recurrent mutations in APC and CTNNB1, indicating that these tumors represent a unique group apart from other established skin tumor types.
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Pharmacobezoar Associated Prolonged Clinical Course in a Patient with Immediate Release Quetiapine Overdose.

J Med Toxicol

October 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: Quetiapine is available in both immediate-release (IR) and extended-release (XR) formulations. Quetiapine XR overdose is known to cause delayed increase in serum quetiapine concentrations. However, it is not certain whether quetiapine IR overdose would similarly cause a delayed increase in serum quetiapine concentrations.

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Purpose: To investigate whether the pivot-shift test reflects patient-reported outcomes 1 year after anterior cruciate ligament (ACL) reconstruction based on a multicentre prospective cohort study.

Methods: This study included patients who underwent primary ACL reconstruction using the hamstring tendons. The pivot-shift test grades were determined according to the International Knee Documentation Committee (IKDC) form as 0, 1+, 2+ or 3+.

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Laser hair removal for esthetic purposes has commonly been performed worldwide. This procedure is considered to be safe and effective, and severe complications such as systemic bacterial infections have seldom been reported. We present a case of native valve infective endocarditis (IE) potentially associated with laser hair removal.

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Controlling pulmonary blood flow in patients who have undergone Norwood palliation, especially early postoperatively, is challenging due to a change in the balance of systemic and pulmonary vascular resistance. We applied a combination therapy of clipping and balloon angioplasty for right ventricle-pulmonary artery (RV-PA) shunt to control pulmonary blood flow, but the influence of the combination therapy on the PA condition is uncertain. Retrospectively analysis was conducted of all infants with hypoplastic left heart syndrome who had undergone Norwood palliation with RV-PA shunt at Okayama University Hospital from January 2008 to September 2022.

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Unusual presentation of spontaneous ruptured hepatocellular carcinoma: Inguinal hernia.

Am J Emerg Med

September 2024

Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima City, Hiroshima 730-8518, Japan.

Article Synopsis
  • Spontaneous ruptured hepatocellular carcinoma (HCC) is a serious medical condition that can be difficult to diagnose due to varied symptoms, despite advances in diagnostic tools and treatment.
  • A case study of a 66-year-old man shows how his presentation with groin pain and swelling, initially suggesting an inguinal hernia, led to the unexpected discovery of ruptured HCC upon surgical exploration.
  • The case highlights the importance for emergency physicians to recognize the diverse ways spontaneous ruptured HCC can manifest, as timely diagnosis is crucial for effective treatment.
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Introduction Despite the critical role of bone marrow aspiration and a trephine biopsy (BMAT) in the diagnosis and management of hematological diseases, research on effective teaching methods is limited. Medical students traditionally learn to perform BMAT through observation and replication, which poses a risk to patient safety. Therefore, we developed a novel BMAT simulator for undergraduate medical students using a simulation-based education program.

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Importance: Treating patients with chronic urticaria using omalizumab has been shown to be safe and effective in randomized clinical trials. Multinational studies on long-term omalizumab performance in chronic urticaria in clinical practice settings are lacking, especially on drug survival. Drug survival, which refers to the length of time that patients are treated with a specific drug, is a comprehensive outcome covering effectiveness, safety, and patient and physician preferences.

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Article Synopsis
  • The study aimed to evaluate how well contrast-enhanced computed tomography (CECT) predicts outcomes for patients with severe acute pancreatitis (SAP) by using the computed tomography severity index (CTSI).
  • A retrospective analysis of 1,097 SAP patients from 44 institutions in Japan found that while necrosis in pancreatic tissue increased mortality risks, the overall inflammation did not significantly impact mortality rates.
  • The results showed that the CTSI had a moderate ability (AUC 0.65) to predict mortality, with significant correlations between higher levels of pancreatic necrosis and increased odds of death.
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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important therapeutic option for patients with hematologic malignancies. However, the development of graft-versus-host disease (GVHD) after allo-HSCT remains a challenge. Although systemic steroid therapy is the established first-line therapy for acute GVHD (aGVHD) and chronic GVHD (cGVHD), many patients are unresponsive or resistant to corticosteroid therapy, and the response is insufficient.

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Sex differences exist in sepsis, but the commitment of neutrophils to these differences remains unclear. Neutrophil extracellular traps (NETs) function to remove pathogens, yet excessive NETs release can contribute to organ damage. This study explores effects of the gender hormones on endotoxin-induced NETs using neutrophils from both male and female sources.

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Chest tube insertion is a common and relatively safe procedure in an emergency setting. However, a potentially fatal complication, vasovagal reflex, may be under-recognized due to its generally mild severity. We present a case of pulseless electrical activity (PEA) requiring chest compression due to vasovagal reflex during chest tube insertion for spontaneous pneumothorax.

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Reply to letter to the editor by Li et al.

J Orthop Sci

September 2024

Department of Orthopaedic Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan.

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The Chronic Angioedema Registry (CARE): Rationale, Methods and Implementation.

Clin Exp Allergy

September 2024

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

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A 24-year-old Japanese female with anorexia nervosa presented to our hospital for bilateral pneumothorax, and 12-Fr thoracostomy catheters were inserted into the bilateral pleural cavities. On hospital day 9, a thoracoscopic bullectomy was performed. However, air leakage relapsed on both sides on postoperative day 1.

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Baseline gut microbiota as a predictive marker for the efficacy of neoadjuvant chemotherapy in patients with early breast cancer: a multicenter prospective cohort study in the Setouchi Breast Project-14.

Breast Cancer Res Treat

November 2024

Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Purpose: Various studies have demonstrated the causal relationship between gut microbiota and efficacy of chemotherapy; however, the impact of gut microbiota on breast cancer has not been fully elucidated. This study aimed to evaluate the associations between the gut microbiota before neoadjuvant chemotherapy and its consequent efficacy in breast cancer.

Methods: This prospective observational study included patients who received neoadjuvant chemotherapy for primary early breast cancer at eight institutions between October 1, 2019, and March 31, 2022.

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