976 results match your criteria: "Jichi Medical University Saitama[Affiliation]"

Some critically ill patients completely rely on parenteral nutrition (PN), which often cannot provide sufficient energy/amino acids. We investigated the relationship between PN doses of energy/amino acids and clinical outcomes in a retrospective cohort study using a medical claims database (≥10.5 years, from Japan, and involving 20,773 adult intensive care unit (ICU) patients on mechanical ventilation and exclusively receiving PN).

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  • * Specific comorbidities, especially infections and moderate/severe hepatic conditions, significantly increased the risk of NRM, with renal comorbidity being highlighted as the most detrimental for OS across both donor groups.
  • * The findings suggest that when selecting unrelated donors for HCT, it's crucial to consider not just the donor's match but also the patient's specific comorbid conditions, like cardiac and renal issues
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Higher rate of nonrelapse mortality (NRM) remains yet to be resolved in umbilical cord blood transplantation (UCBT). Considering that UCBT has some unique features compared with allogeneic hematopoietic cell transplantation from other graft sources, a UCBT-specific NRM risk assessment system is required. Thus, in this study, we sought to develop a UCBT-specific NRM Risk Assessment (CoBRA) score.

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  • The study aimed to determine the best tissue perfusion measurement for initial treatment in adults with sepsis or septic shock through a network meta-analysis.
  • Researchers analyzed data from 17 randomized trials, focusing on short-term mortality within 90 days as the primary outcome.
  • The findings indicated that both lactate-guided and capillary refill time-guided therapies significantly reduced short-term mortality, while central venous oxygen saturation-guided therapy was linked to increased mortality risk.
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Aim: Assessing the indication for elective neuro-endovascular treatment (EVT) in older patients requires consideration of the impact of systemic comorbidities on their overall reduced life expectancy. The objective of this study was to determine the long-term outcomes of elective neuro-EVT in patients aged ≥80 years, and to investigate the impact of pre-existing cancer on their long-term outcomes.

Methods: Of the patients enrolled in multicenter observational registry, those aged ≥80 years undergoing elective neuro-EVT between 2011 and 2020 were enrolled.

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  • - A patient with FLT3-mutated acute promyelocytic leukemia (APL) relapsed despite treatment with all-trans retinoic acid (ATRA) and chemotherapy, as well as re-induction therapy with arsenic trioxide and high-dose cytarabine, which failed to achieve remission.
  • - The leukemic cells resisted conventional therapies; therefore, the medical team opted for gilteritinib, a selective FLT3 inhibitor, as an alternative treatment option.
  • - The patient achieved complete hematologic remission with gilteritinib, highlighting its potential effectiveness as a single-agent therapy for patients with resistant FLT3-mutated APL prior to transplantation.
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  • The phase 3 JAVELIN Renal 101 trial showed that first-line treatment with avelumab plus axitinib improves objective response rate (ORR) and progression-free survival (PFS) in patients with advanced renal cell carcinoma (aRCC) compared to sunitinib.
  • A retrospective study in Japan analyzed clinical data from 48 aRCC patients treated with avelumab plus axitinib, revealing a 48.8% ORR and a median PFS of 15.3 months, with a median follow-up of 10.4 months.
  • The study found that 50% of patients were still on treatment at the cutoff, and the
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  • * Data from over 10,000 patients revealed no significant differences in overall survival or complications between the two methods, but PB recipients had a higher rate of chronic graft-versus-host disease (GVHD), impacting long-term survival quality.
  • * Findings suggest that while both sources are viable, BM might be more beneficial for certain patients, particularly those with specific types of cancers or higher comorbidity, emphasizing the need for personalized transplant strategies.
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Allogeneic hematopoietic cell transplantation (allo-HCT) is the sole curative therapy for myelodysplastic syndrome (MDS). In the absence of an HLA-matched sibling donor, an HLA-matched unrelated donor (MUD) is considered the leading candidate. However, in recent decades, the alternative donor pool has been extended to HLA-haploidentical donors, especially with the development of graft-versus-host disease (GVHD) prophylaxis using post-transplantation cyclophosphamide (PTCy).

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Background: Human T-cell leukemia virus type I (HTLV-1) is a retrovirus known to cause adult T-cell leukemia/lymphoma (ATL). There are few reports on hematopoietic stem cell transplantation (HSCT) for HTLV-1 carriers with diseases other than ATL.

Methods: A total of 25,839 patients (24,399 adults and 1440 children) with pre-transplant HTLV-1 serostatus information recorded in the Japanese National Survey Database who had undergone their first HSCT were analyzed.

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Various complications can influence hematopoietic cell transplantation (HCT) outcomes. Renal complications can occur during the early to late phases of HCT along with various factors. However, studies focusing on fatal renal complications (FRCs) are scarce.

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  • Rab7 is important in cellular processes like autophagy and endocytosis, and its role in pancreatitis has been highlighted, but its function in exocytic pancreatic cells is still not fully understood.
  • In a study using pancreas-specific Rab7 knockout mice, researchers found that Rab7 colocalizes with amylase in normal mice, indicating its role in zymogen granule (ZG) membranes but not in amylase secretion during stimulation.
  • Electron microscopy showed that ZGs were smaller and more abundant in the absence of Rab7, suggesting that Rab7 is crucial for the maturation of these granules, but does not affect their autophagy or secretion in pancreatic acinar cells.
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A woman in her 90s with chronic uterine prolapse presented with abdominal pain and a vaginal mass. The patient had generalised peritonitis and a strangulated bowel obstruction originating from a perforated posterior vagina. We performed partial intestinal resection and a total hysterectomy, including excision of the perforation of the vaginal site and the adnexa.

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  • Acute myeloid leukemia (AML) is commonly treated with allogeneic hematopoietic cell transplantation (HCT), and new donor options are available for older patients lacking HLA-matched siblings.
  • This study analyzed outcomes from 5,704 AML patients over 50 years old who received HCT from various donor types between 2013 and 2021, focusing on survival and leukemia-free survival (LFS).
  • Findings revealed that donor type did not significantly affect overall survival, but 8/8 allele-matched and unrelated cord blood donors showed better LFS compared to matched sibling donors, while relapse rates were lower for these donor types.
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  • The study explored the effectiveness of a treatment regimen called ABCP (atezolizumab, bevacizumab, carboplatin, and paclitaxel) for patients with EGFR-mutated non-small cell lung cancer (NSCLC) after failure of EGFR-tyrosine kinase inhibitors (TKIs).
  • Results from 60 patients showed a median progression-free survival (PFS) of 7.4 months and median overall survival (OS) of 23.1 months, with an overall response rate (ORR) of 55.9%.
  • However, the study did not reach its primary endpoint and indicated that PFS was notably shorter for patients with previous TKI treatment and those with brain or
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Objectives: Patients undergoing cardiac surgery often require blood transfusions, which are associated with increased morbidity and mortality. Patient blood management (PBM) strategies, including acute normovolemic hemodilution (ANH), have been implemented to minimize allogeneic transfusion requirements. Older studies suggested that ANH is associated with reduced transfusions; however, its effectiveness in the modern era of PBM remains unclear.

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Background: Temporal trends in the management of acute coronary syndrome complicated with cardiogenic shock after the revision of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella require further investigation, because their impact remains uncertain.

Methods And Results: Using the Japanese Percutaneous Coronary Intervention (J-PCI) registry database from 2019 to 2021, we identified 12 171 patients undergoing percutaneous coronary intervention for acute coronary syndrome complicated with cardiogenic shock under mechanical circulatory support. The patients were stratified into 3 groups: (1) IABP alone, (2) Impella, and (3) venoarterial extracorporeal membrane oxygenation (VA-ECMO); the VA-ECMO group was further stratified into (3a) VA-ECMO alone, (3b) VA-ECMO in combination with IABP, and (3c) VA-ECMO in combination with Impella.

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Objective: Inflammatory bowel disease (IBD) is closely related to stress and fatigue. Human herpesvirus 6B (HHV-6B) is reactivated by stress and fatigue and is associated with IBD. This study aimed to clarify the relationship between IBD and HHV-6B.

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Background Previous studies have demonstrated a correlation between management by intensivists and a decrease in hospital stay and mortality, yet the underlying reason remains unknown. Using open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) and other databses, the present study aimed to explore the relationship between inotrope and vasoconstrictor use and the number of intensivists. Materials and methods Cardiovascular agonists listed in the 2020 NDB for which the total dose was known were included for analysis.

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Background: The factors that predict the clinical response to ramucirumab plus docetaxel (RD) after first-line chemoimmunotherapy are unresolved. We explored whether the therapeutic efficacy of prior chemoimmunotherapy could predict the outcome of RD as sequential therapy in patients with advanced non-small cell lung cancer (NSCLC).

Methods: Our study comprised 288 patients with advanced NSCLC who received RD as the second-line treatment after first-line chemoimmunotherapy at 62 Japanese institutions.

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  • - This study investigated the relationship between the severity of contrast extravasation (CE) seen on CT scans and the need for massive transfusions (MT) in children with blunt liver and/or spleen injuries, over a span from 2008 to 2019.
  • - The research included 1,407 pediatric patients, revealing that 14% required MT, and specific types of CE, particularly intraparenchymal and into the peritoneal cavity, significantly correlated with increased transfusion needs.
  • - The findings suggest that recognizing active CE during initial CT scans can guide healthcare providers in making informed decisions about transfusion strategies for young patients with these types of injuries.
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Comparison of Clinical Outcomes Among Various Percutaneous Coronary Intervention Strategies for Small Coronary Artery Disease.

Am J Cardiol

January 2024

Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Division of Cardiology, Jacobi Medical Center, Albert Einstein College of Medicine, New York, New York. Electronic address:

It remains unclear which percutaneous coronary intervention (PCI) strategy is the most preferable in patients with small-vessel coronary artery disease (CAD). We sought to evaluate the clinical efficacy of various PCI strategies for patients with small-vessel CAD through a network meta-analysis of randomized controlled trials (RCTs). We searched multiple databases for RCTs investigating the efficacy of the following PCI strategies for small-vessel CAD (<3 mm in diameter): drug-coated balloons (DCB), early-generation paclitaxel-eluting stents and sirolimus-eluting stents (SES), newer-generation drug-eluting stents (DES), bare-metal stents (BMS), cutting balloon angioplasty, and balloon angioplasty (BA).

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Background: Total knee arthroplasty (TKA) alleviates pain and improves daily living activities in individuals with end-stage osteoarthritis of the knee. However, up to 20% of patients have sub-optimal outcomes after TKA.

Objective: No studies have clarified the intraoperative factors that affect postoperative range of motion (ROM) after cruciate-retaining (CR) TKA.

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