84 results match your criteria: "Kasukabe-chuo General Hospital[Affiliation]"

Spinal cord stimulation trial can control pain caused by chronic limb-threatening ischemia.

JPRAS Open

December 2024

Limb Salvage Center, Kasukabe Chuo General Hospital, 344-0063 midori5-9-4, Kasukabe, Saitama, Japan.

Background: Patients with chronic limb-threatening ischemia experience long-duration pain during ulcer treatment. Hence, painkillers are gradually increased, but adverse events often occur. Spinal cord stimulation trial is one of the methods used to manage such pain.

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Objective: This study aimed to determine the impact of infrapopliteal (IP) revascularisation establishing in line flow to the wound (IFW) on wound healing in chronic limb threatening ischaemia (CLTI), using a core laboratory assessment for wounds and in line flow.

Methods: The Wound directed Angiosome RevasculaRIsation apprOach to patients with cRitical limb iSchaemia (WARRIORS) multicentre observational study enrolled patients with CLTI with tissue loss undergoing IP revascularisation in Japan, with scheduled two year follow up. The primary outcome measure was complete wound healing, defined as achievement of complete epithelialisation of all wounds without major amputation.

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Article Synopsis
  • The study aimed to validate the Japanese below-the-knee (J-BTK) chronic total occlusion (CTO) score as a predictor for successful guidewire crossing (S-GC) in patients undergoing endovascular therapy.
  • Conducted at 16 medical centers, the study included 751 BTK CTOs in 497 patients, categorizing them based on their S-GC outcomes using a scoring system that assesses factors like entry type, calcification, vessel diameter, CTO length, and target vessel outflow.
  • Results showed that higher J-BTK CTO scores correlated with lower S-GC success rates, and a modified version of the score, which included points for de novo lesions, further improved prediction accuracy for the likelihood
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Objective: To evaluate the healing outcome of a platelet-rich plasma (PRP) gel prepared using TKKT01 (a wound care device to prepare the PRP gel) in patients with hard-to-heal diabetic foot ulcers (DFUs) and who showed an inadequate response to ≥4 weeks of standard of care (SoC).

Method: This open-label, single-arm, multicentre study was conducted in 15 centres in Japan. Eligible patients received PRP gel treatment twice a week for eight weeks, followed by a final evaluation after the completion of week 8 (day 57).

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  • * Researchers assessed 77 lower limb arteries from 36 patients, utilizing detailed histological analysis to quantify calcification severity.
  • * Results indicated significant correlations between HD status and increased calcification severity, particularly in below-the-knee lesions, highlighting the risks associated with HD.
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Purpose: In the present trial, the 24-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and proximal popliteal artery (PA) were evaluated in Japanese patients.

Methods: This was a prospective, multicenter, core laboratory-adjudicated, single-arm trial. From 2019 to 2020, 121 patients with symptomatic peripheral artery disease were enrolled.

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Article Synopsis
  • * The three treatment strategies analyzed were balloon angioplasty-alone, primary stenting, and provisional stenting, with significant differences in two-year MALE rates, where balloon angioplasty showed the poorest outcomes.
  • * After changing strategies, the final MALE rates among all treatment groups were similar, suggesting that physicians generally made appropriate decisions when selecting treatment strategies for EVT of the femoropopliteal artery.
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Background: Chronic limb-threatening ischemia (CLTI) is a severe peripheral artery disease with rest pain and lower limb ulceration. After revascularization, limb ulceration treatment should be completed quickly before restenosis. We aimed to investigate the effect of negative pressure wound therapy with instillation and dwell (NPWTi-d) using an antiseptic solution (AS) versus a saline solution (SS) in CLTI.

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This case highlights the biomechanical influence of toe amputation on contralateral limb force elevation, possibly through reduced ipsilateral plantar flexor torque production. These findings provide insight into toe amputation-related compensatory gait mechanics with greater inter-limb asymmetry, which may increase the risk of musculoskeletal comorbidities, including osteoarthritis in contralateral limb.

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Background: Drug-coated balloons (DCBs) have significantly changed endovascular therapy (EVT) for femoropopliteal artery (FPA) disease, in terms of the expansion of indications for EVT for symptomatic lower extremity arterial disease (LEAD). However, whether there is a difference in the performance among individual DCBs has not yet been fully discussed. The present sub-analysis of real-world data from a prospective trial of first-generation DCBs compared the clinical outcomes between high- and low-dose DCBs using propensity score matching methods.

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Article Synopsis
  • The study aimed to explore the link between repeated proteinuria (presence of proteins in urine) and cardiovascular events in middle-aged and older Japanese individuals.
  • Conducted as a retrospective cohort study, it analyzed health screening and medical claim data from a large health insurer, focusing on participants aged 40-74 who had kidney function screenings at least twice.
  • Results indicated that individuals with Repetitively-positive proteinuria had a significantly higher risk of major cardiovascular events compared to those with Once-positive and All-negative results, highlighting the importance of monitoring protein levels in urine for cardiovascular health.
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Social Isolation/Loneliness and Tooth Loss in Community-Dwelling Older Adults: The Sukagawa Study.

Innov Aging

June 2023

Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan.

Article Synopsis
  • The study examined the link between social isolation/loneliness and tooth loss in older Japanese adults, analyzing responses from 4,645 participants aged 75 and older from the Sukagawa Study.
  • Results indicated that loneliness was significantly associated with tooth loss and reduced oral care behaviors, while social isolation did not show a similar link.
  • The findings suggest that addressing loneliness could be important for improving oral health among elderly populations, which may help guide policymakers and healthcare professionals.
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Rehabilitation is usually provided to patients with chronic foot wounds (CFWs) after surgery. This study aimed to assess whether early postoperative rehabilitation could maintain walking independence in hospitalized patients with CFWs. This single-blind, randomized clinical trial was performed between September 10, 2018 and March 2019, involving 60 patients who underwent both surgical procedures and rehabilitation.

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Background: Carnitine deficiency is common in patients with chronic kidney disease (CKD) who require dialysis. Several clinical studies have suggested that carnitine supplementation is beneficial for dialysis-related symptoms. However, the clinical effectiveness and potential adverse effects of carnitine supplementation in dialysis patients have not been determined.

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Purpose: The aim of this preapproval trial was to evaluate the 12-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and/or proximal popliteal artery (PA).

Methods: This was a prospective, multicenter, core laboratory adjudicated, single-arm trial. From October 2019 to November 2020, a total of 121 symptomatic peripheral artery disease patients with SFA and/or proximal PA lesions were enrolled.

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Peripheral artery disease (PAD) and atrial fibrillation (AF) are associated with major cardiovascular and cerebrovascular events (MACCE). However, outcomes stratified according to the preoperative symptoms of PAD in patients with AF have not been sufficiently investigated. This was a retrospective study of prospectively collected data pertaining to 2237 patients (1179 patients with intermittent claudication [IC] and 1058 patients with critical limb-threatening ischemia [CLTI]) who underwent endovascular therapy at 34 hospitals between August 2014 and August 2016.

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Article Synopsis
  • The study aimed to explore how common sarcopenic obesity is among older heart failure patients, its link to physical fitness and frailty, and its impact on survival.
  • Researchers analyzed data from 779 hospitalized older adults, finding that 19.3% had sarcopenia and 26.2% were classified as obese, with specific cutoff points for body fat.
  • Results indicated that those with both sarcopenia and obesity had poorer physical performance and a significantly higher risk of death within a year, establishing sarcopenic obesity as a serious health concern in this group.
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Three years progress chronic limb-threatening ischemia case with simultaneous surgery.

Int J Surg Case Rep

June 2022

Limb Salvage Center, Kasukabe Chuo General Hospital, 344-0063 midori5-9-4, Kasukabe, Saitama, Japan.

Introduction And Importance: Chronic limb-threatening ischemia (CLTI) is a severe limb problem. The causes of foot ulcer are influenced by several factors, which lead to ischemia and foot deformity causing recurrence after wound healing. This report focuses on the long-term course.

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Man in his 30s was diagnosed with type B acute aortic dissection with malperfusion syndrome. Emergent endovascular therapy assisted by intravascular ultrasound was performed due to the unavailability of the neighbourhood cardiovascular surgeons and stored stent grafts. Stenting at the dissected superior mesenteric artery resolved the malperfusion syndrome.

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Article Synopsis
  • The study investigates the prevalence and prognostic impact of cognitive frailty in elderly heart failure (HF) patients, highlighting its significance for long-term outcomes.
  • Conducted on 1215 patients aged 65 and older, findings revealed that 23% displayed cognitive frailty, linked to a higher risk of mortality and rehospitalization.
  • The results showed that cognitive frailty increased the risk of adverse events by 1.55 times, emphasizing the importance of monitoring both cognitive and physical health in older patients with HF.
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Although postural hypotension (PH) is reportedly associated with mortality in the general population, the prognostic value for heart failure is unclear. This was a post-hoc analysis of FRAGILE-HF, a prospective multicenter observational study focusing on frailty in elderly patients with heart failure. Overall, 730 patients aged ≥ 65 years who were hospitalized with heart failure were enrolled.

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Aims: A patient's understanding of his or her own comorbidities is part of the recommended patient education for those with heart failure. The accuracy of patients' understanding of their comorbidities and its prognostic impact have not been reported.

Methods And Results: Patients hospitalized for heart failure (n = 1234) aged ≥65 years (mean age: 80.

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Sex differences in the prevalence and prognostic impact of physical frailty and sarcopenia among older patients with heart failure.

Nutr Metab Cardiovasc Dis

February 2022

Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan.

Article Synopsis
  • Frailty and sarcopenia are prevalent issues in elderly heart failure patients, with higher rates seen in women for frailty and in men for sarcopenia.
  • Both conditions significantly impact the risk of 1-year mortality in heart failure patients, although frailty specifically predicted mortality only in men.
  • The study found no significant gender interactions influencing the prognostic impact of frailty or sarcopenia, emphasizing that both conditions are detrimental for older patients regardless of sex.
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