The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.

Introduction: This analysis aimed to evaluate the long-term cost-effectiveness of tirzepatide 5 mg versus dulaglutide 0.75 mg (both administered once weekly) in people not achieving glycemic control on metformin, based on the results of the head-to-head SURPASS J-mono trial from a Japanese healthcare payer perspective.

Methods: A cost-utility analysis was performed over a 50-year time horizon using an implementation of the UKPDS Outcomes Model 2 developed in Microsoft Excel.

Lack of an association between spleen volume and risk of pneumococcal infection in cancer patients: a nested case-control study.

Background: The spleen is a key organ in preventing pneumococcal infection, especially in patients with immunocompromised condition such as those with cancer. Previous studies have shown that a small spleen volume in pneumococcal pneumonia patients is associated with severe disease course. However, it is unknown whether a small spleen increases risk of pneumococcal infection.

Associations of sarcopenia and malnutrition with 30-day in-hospital morbidity and mortality after cardiac surgery.

Objectives: Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery.

Methods: We retrospectively analyzed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan.

Clinical Features of Varicella-Zoster Virus-Associated Anterior Uveitis with or without Ophthalmic Herpes Zoster.

Purpose: This study aimed to investigate the clinical characteristics, diagnostic markers, and treatment outcomes of varicella-zoster virus-associated anterior uveitis (VZV-AU) with and without ophthalmic herpes zoster (herpes zoster ophthalmicus (HZO) and zoster sine herpete (ZSH), respectively).

Methods: Clinical records of 47 VZV-AU patients (21 ZSH, 26 hZO) were retrospectively reviewed for clinical findings, medication use, and PCR using aqueous humor (AH) results.

Results: There was no significant difference in age, gender, visual acuity (VA), or intraocular pressure (IOP) between the two groups.

Lateral Planar Imaging of Tc-pyrophosphate Scintigraphy in Patients with Suspected Transthyretin Cardiac Amyloidosis.

: Lateral planar Tc-pyrophosphate (PYP) imaging is recommended as a standardized acquisition method because it helps separate extracardiac uptake from the myocardium. We evaluated its discriminatory performance in detecting myocardial PYP uptake, using single-photon emission computed tomography (SPECT) as a reference standard. : We retrospectively evaluated 170 patients who underwent PYP imaging for suspected transthyretin cardiac amyloidosis.

Recurrent cervicothoracic spontaneous epidural hematoma in a toddler.

Background: Recurrent cases of spontaneous spinal epidural hematoma are rare, and there are no reports of spontaneous resolution and recurrence in toddlers.

Case Presentation: We present a case of a toddler with a cervical spontaneous spinal epidural hematoma, characterized by three episodes of sudden-onset transient torticollis with subsequent natural recovery. The patient was referred to our hospital after the second episode, during which symptoms were already improving.

A Case of Lung Cancer Exhibiting Pleoymorphic Carcinoma Transformation Resistance Following Treatment With Osimertinib That Was Successfully Treated Using Local Ablative Treatment.

Various studies have reported resistance mechanisms and treatment methods after epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor treatment; however, treatment policies have not yet been established, and few cases have reported transformation to pleomorphic carcinoma (PC) as the resistance mechanism. Herein, we report the case of a 66-year-old woman who was diagnosed with Stage 4A lung adenocarcinoma (cT2bN0M1b) through bronchoscopic biopsy. Genetic profiling revealed an EGFR L858R mutation; therefore, osimertinib was administered as the first-line therapy and achieved a partial response.

Machine learning evaluation of intensified conditioning on haematopoietic stem cell transplantation in adult acute lymphoblastic leukemia patients.

Background: The advantage of intensified myeloablative conditioning (MAC) over standard MAC has not been determined in haematopoietic stem cell transplantation (HSCT) for adult acute lymphoblastic leukemia (ALL) patients.

Methods: To evaluate heterogeneous effects of intensified MAC among individuals, we analyzed the registry database of adult ALL patients between 2000 and 2021. After propensity score matching, we applied a machine-learning Bayesian causal forest algorithm to develop a prediction model of individualized treatment effect (ITE) of intensified MAC on reduction in overall mortality at 1 year after HSCT.

Postoperative Time-of-Flight Magnetic Resonance Angiography Classification is a Predictor of Postoperative Recanalization of Unruptured Cerebral Aneurysms.

Background: Endovascular treatment has become the preferred approach for managing unruptured cerebral aneurysms, with simple and balloon-assisted coil embolization as the standard first-line therapy. However, recanalization after coil embolization remains a major clinical concern. This study aimed to evaluate the predictive factors for recanalization using time-of-flight magnetic resonance (TOF-MR) angiography.

Oncological safety of minimally invasive surgery in borderline ovarian tumor and ovarian cancer: a retrospective comparative study.

Objective: This study aimed to evaluate the oncological safety of laparoscopic surgery for patients with benign tumors who underwent laparoscopic surgery at our facility and were subsequently diagnosed with borderline ovarian tumors or ovarian cancer.

Methods: We conducted a retrospective review of 45 patients initially diagnosed with benign ovarian tumors who underwent laparoscopic surgery at our institution from January 2009 to April 2024.

Results: Postoperative pathological examination identified 32 cases of borderline ovarian tumors and 13 cases of ovarian cancer.

Different impacts of granulocyte colony-stimulating factor administration on allogeneic hematopoietic cell transplant outcomes for adult acute myeloid leukemia according to graft type.

We retrospectively evaluated the impacts of using granulocyte colony-stimulating factor (G-CSF) and its timing on posttransplant outcomes for 9766 adults with acute myeloid leukemia (AML) between 2013 and 2022 using a Japanese database. We separately evaluated three distinct cohorts based on graft type: 3248 received bone marrow transplantation (BMT), 3066 received peripheral blood stem cell transplantation (PBSCT), and 3452 received single-unit cord blood transplantation (CBT). Multivariate analysis showed that G-CSF administration significantly accelerated neutrophil recovery after BMT, PBSCT, and CBT.

[A CASE OF CASHEW NUT-RELATED CITRUS SEED ALLERGY WITH SUSPECTED CITRIN INVOLVEMENT].

The case is a 12-year-old girl. She was diagnosed with cashew nut allergy in infancy. She experienced the following allergic symptoms at age 11: sore throat after ingesting gummy bears containing citrus-derived pectin; sore throat, nausea, and severe abdominal pain after ingesting jelly containing yuzu (citrus junos) seeds and peel.

Blue toe syndrome - systemic cholesterol crystal embolism secondary to cardiovascular procedures: a forensic autopsy report of two cases.

Blue toe syndrome, also referred to as cholesterol crystal embolism is characterized by the distal embolization of cholesterol crystals originating from ruptured atherosclerotic plaques. This condition commonly arises in the context of cardiovascular procedures. Emboli from the thoracoabdominal aorta primarily affect the downstream extremities and intra-abdominal viscera, often resulting in fatal atheroembolic renal failure.

Association between early anti-cytomegalovirus therapy and the incidence of chronic graft-versus-host disease.

Ganciclovir and foscarnet are two representative anti-cytomegalovirus (CMV) agents. A previous regional study revealed a lower risk of chronic graft-versus-host disease (GVHD) in patients who received pre-emptive foscarnet. We conducted a retrospective nationwide study to confirm the results.

Cribriform Pattern Is a Predictive Factor of PSA Recurrence in Patients Receiving Radiotherapy After Prostatectomy.

Background/aim: In prostate cancer, robotic total prostatectomy is a popular treatment modality. However, prostate-specific antigen (PSA) recurrence after prostate cancer surgery remains a concern. Salvage radiotherapy is commonly used to treat PSA recurrence, but the recurrence rate after salvage radiotherapy is high, highlighting the need for better predictive markers.

Comparing de novo chronic myeloid leukemia in blastic phase with Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic hematopoietic cell transplantation.

Background: De novo chronic myeloid leukemia in blastic phase (CML-BP) showing lymphoid immunophenotype mimics Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL). Although upfront allogeneic hematopoietic cell transplantation (HCT) is considered in both diseases, it is not yet clear whether the transplant outcomes are also similar.

Methods: Using a registry database, the transplant outcomes between de novo CML-BP and Ph-positive ALL in negative-minimal residual disease (MRD), positive MRD, and nonremission cohorts were compared, respectively.

Tele-education in point-of-care ultrasound training.

Background: Traditionally, ultrasound skills have been taught through a one-on-one approach, where instructors physically guide learners' hands at the bedside or in the workshop. However, this method is frequently challenged by scheduling and cost limitations. Our objective was to create a tele-education model for point-of-care ultrasound training and evaluate its effectiveness and its impact on learners' perceived workload compared to conventional education and self-directed learning methods.

Clinical Profiles of Leucine-Rich Alpha-2 Glycoprotein for Indicating Mucosal Healing in Ulcerative Colitis Patients under Administration of Molecular-Targeted Drug.

Introduction: Leucine-rich alpha-2 glycoprotein (LRG) is a useful serum biomarker for monitoring disease activity during remission in ulcerative colitis (UC). Because LRG levels differ among patients, it is necessary to assess them after profiling patients, especially in patients with refractory UC undergoing treatment with molecular-targeted drugs. This study aimed to analyze LRG levels that indicate mucosal healing according to clinical characteristics and molecular-targeted drugs.

Female-to-male allogeneic transplantation affects outcomes differently according to the type of haplo-transplantation.

Allogeneic hematopoietic stem cell transplantation from a female donor to a male recipient (female-to-male allo-HCT) is a well-established risk factor for chronic graft-versus-host disease (GVHD) and non-relapse mortality (NRM). The inferior outcomes of female-to-male allo-HCT are considered to be due to allo-immunity against H-Y antigens. However, the influence of minor histocompatibility antigens in haplo-identical allo-HCT remains to be elucidated.