31 results match your criteria: "Keio University School of Medicine Graduate School of Medicine[Affiliation]"

Article Synopsis
  • The study investigates the link between duodenal epithelial tumors (DETs) and colorectal tumors, addressing a controversial topic in familial colorectal adenomatous polyposis.
  • Conducted over four years, the research compared 163 patients with DETs to 177 individuals undergoing routine colonoscopy, finding a significantly higher adenoma detection rate (ADR) in the DET group (63.2% vs 23.6%).
  • The results indicated that DETs are associated with a five-fold increase in adenoma detection and a six-fold increase in advanced neoplasia detection, suggesting the need for screening colonoscopy in DET patients.
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Background: Two decades have passed since the beginning of the Iraq War in 2003. Iraq has long suffered from conflicts and instability, where the people have limited access to healthcare. The coronavirus disease (COVID-19) pandemic brought additional disruption to health service provision.

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  • The lupus low disease activity state (LLDAS) allows some activity in systemic lupus erythematosus (SLE) as long as it stays within certain limits; this study examined the outcomes of patients achieving LLDAS with different levels of activity.
  • A total of 2,099 SLE patients were analyzed over a median follow-up of 3.5 years, revealing that 20.8% had clinical activity, 50.4% had serological activity only, and 28.8% had neither while in LLDAS.
  • Results indicated that all LLDAS subsets reduced the risk of disease flares and damage, with LLDAS showing no activity being the most protective against severe flares.
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  • The study investigates the safety and effectiveness of endoscopic submucosal dissection (ESD) for colorectal and gastric cancers, focusing on predicting resectability using endoscopic ultrasound (EUS).
  • EUS classifications for tumors were established, determining how visible the submucosal layer was, and the findings showed a significant correlation with the pathological results following ESD.
  • The results indicated that EUS could be crucial in predicting which tumors are likely to be successfully resected, with higher success rates observed in Type I tumors compared to Type II and III.
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Objectives: Interventions to address psychosocial healthcare issues in older adults are increasing. Realist evaluation (RE) helps us understand how these interventions work for their issues. It is significant to obtain implications for further developing such research.

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Article Synopsis
  • - The study investigates long COVID symptoms among 935 patients in Japan, categorizing them into five distinct clusters based on various symptom presentations and their impact on quality of life (QOL).
  • - The clusters include: numerous symptoms affecting multiple organs, minimal symptoms, taste and smell disorders, fatigue with psychological symptoms, and fatigue with respiratory issues, showcasing a diverse range of long COVID experiences.
  • - Findings highlight the need for personalized treatment approaches, as the severely affected patients (mostly elderly in cluster 1) experienced the greatest decline in QOL, while other clusters showed different symptom trends and demographic profiles.
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Stargardt macular dystrophy (Stargardt disease; STGD1; OMIM 248200) is the most prevalent inherited macular dystrophy. STGD1 is an autosomal recessive disorder caused by multiple pathogenic sequence variants in the large gene (OMIM 601691). Major advances in understanding both the clinical and molecular features, as well as the underlying pathophysiology, have culminated in many completed, ongoing and planned human clinical trials of novel therapies.

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Objectives: To investigate the efficacy and safety of otilimab, an antigranulocyte-macrophage colony-stimulating factor antibody, in patients with active rheumatoid arthritis.

Methods: Two phase 3, double-blind randomised controlled trials including patients with inadequate responses to methotrexate (contRAst 1) or conventional synthetic/biologic disease-modifying antirheumatic drugs (cs/bDMARDs; contRAst 2). Patients received background csDMARDs.

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Colorectal endoscopic submucosal dissection (ESD) remains challenging for novice endoscopists. Not only the underwater conditions but also active use of water pressure with the water pressure method (WPM) can help widen the submucosal layer. This study aimed to clarify the usefulness of WPM in colorectal ESD, especially for novice endoscopists.

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Article Synopsis
  • Serum KL-6 is a biomarker that can help predict critical outcomes in COVID-19 patients, showing significantly higher levels in those with severe cases compared to milder ones.
  • In a study of 2,226 Japanese COVID-19 patients, a serum KL-6 level of ≥304 U/mL was a strong predictor of critical outcomes.
  • The mucin 1 variant was correlated with increased KL-6 levels but did not show a significant relationship with the severity of COVID-19 outcomes.
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Objective: Skeletal muscle mass (SMM) is an important biomarker for prognosis and health in older patients with cancer. Limited information is available on the recovery course of SMM after oesophagectomy following neoadjuvant chemotherapy (NAC) in older patients. This study was performed to investigate the recovery course of SMM after oesophagectomy following NAC and the preoperative predictors of delayed recovery in older patients with locally advanced oesophageal cancer (LAEC).

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Article Synopsis
  • A follow-up survey conducted in 2022 assessed radiation protection practices among medical staff in endoscopy-fluoroscopy departments in Japan, following a 2020 study that reported low protective equipment usage and insufficient knowledge.
  • The survey included 464 participants, with high lead apron usage (98%) but much lower rates for other gear like thyroid collars (27%) and lead glasses (35%), indicating limited improvement since the 2020 survey.
  • While many staff attended radiation protection lectures (76%) and were aware of key concepts such as cancer risk related to radiation exposure, knowledge about specific dosage limits and diagnostic reference levels remained low, signaling further educational needs.
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Background: Early fast-acting treatment (EFT) is the aggressive use of fast-acting therapies such as plasmapheresis, intravenous immunoglobulin and/or intravenous high-dose methylprednisolone (IVMP) from the early phases of treatment. EFT is reportedly beneficial for early achievement of minimal manifestations (MM) or better status with ≤5 mg/day prednisolone (MM5mg), a practical therapeutic target for myasthenia gravis (MG).

Objective: The current study aimed to clarify which specific EFT regimen is efficacious and the patient characteristics that confer sensitivity to EFT.

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This systematic literature review (SLR) regarding the efficacy, duration of use and safety of glucocorticoids (GCs), was performed to inform the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis (RA). Studies on GC efficacy were identified from a separate search on the efficacy of disease-modifying antirheumatic drugs (DMARDs). A combined search was performed for the duration of use and safety of GCs in RA patients.

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Objectives: To perform a systematic literature review (SLR) concerning the safety of synthetic(s) and biological (b) disease-modifying antirheumatic drugs (DMARDs) to inform the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis (RA).

Methods: SLR of observational studies comparing safety outcomes of any DMARD with another intervention in RA. A comparator group was required for inclusion.

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Article Synopsis
  • A systematic review of literature from 2012 to 2020 evaluated the efficacy and safety of biological disease-modifying antirheumatic drugs targeting the IL-6 pathway for immune-mediated inflammatory diseases.
  • The review identified 187 relevant studies, showing positive outcomes for conditions like rheumatoid arthritis and giant cell arteritis, while noting no benefits for psoriatic arthritis and ankylosing spondylitis.
  • The safety profile of IL-6 inhibitors is generally comparable to other drugs in the same class, with specific risks such as diverticulitis and gastrointestinal perforations in some cases.
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Study Design: A modified Delphi study.

Objective: To assess current practice patterns in the management of cervical spinal cord injury (SCI) and develop a simplified, practical classification system which offers ease of use in the acute setting, incorporates modern diagnostic tools and provides utility in determining treatment strategies for cervical SCI.

Methods: A three-phase modified Delphi procedure was performed between April 2020 and December 2021.

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Objective: Many cancers engage embryonic genes for rapid growth and evading the immune system. SOX9 has been upregulated in many tumours, yet the role of SOX9 in mediating immunosuppressive tumour microenvironment is unclear. Here, we aim to dissect the role of SOX9-mediated cancer stemness attributes and immunosuppressive microenvironment in advanced gastric adenocarcinoma (GAC) for novel therapeutic discoveries.

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Background: Targeting interleukin (IL)-6 has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease. Interference with the IL-6 pathway can be directed at the specific receptor using anti-IL-6Rα antibodies or by directly inhibiting the IL-6 cytokine. This paper is an update of a previous consensus document, based on most recent evidence and expert opinion, that aims to inform on the medical use of interfering with the IL-6 pathway.

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Objectives: To investigate metabolite alterations in the plasma of SLE patients to identify novel biomarkers and provide insight into SLE pathogenesis.

Methods: Patients with SLE (n = 41, discovery cohort and n = 37, replication cohort), healthy controls (n = 30 and n = 29) and patients with RA (n = 19, disease control) were recruited. Metabolic profiles of the plasma samples were analysed using liquid chromatography-time-of-flight mass spectrometry and capillary electrophoresis-time-of-flight mass spectrometry.

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We herein report a case of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL) that was incidentally detected by fluorodeoxyglucose-positron emission tomography (F-FDG PET)/computed tomography (CT) at a health checkup. At that time, the findings of a physical examination and blood tests were all normal, except for the diffuse bone marrow uptake (maximum standardized uptake value: 6.3).

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Objective: To report long-term safety from the completed extension trial of baricitinib, an oral selective Janus kinase inhibitor, in patients with active rheumatoid arthritis (RA).

Methods: Treatment-emergent adverse events are summarised from an integrated database (9 phase III/II/Ib and 1 long-term extension) of patients who received any baricitinib dose (All-bari-RA). Standardised incidence ratio (SIR) for malignancy (excluding non-melanoma skin cancer (NMSC)) and standardised mortality ratio (SMR) were estimated.

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Aims/introduction: Knowing the collective clinical factors that determine patient response to glucose-lowering medication would be beneficial in the treatment of type 2 diabetes. We carried out a retrospective cohort study to explore the combination of clinical factors involved in its therapeutic efficacy.

Materials And Methods: The results of cohort studies retrieved using the CoDiC database across Japan from January 2005 to July 2018 were analyzed based on criterion that using insulin therapy indicates severe type 2 diabetes.

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