342 results match your criteria: "Kishiwada City Hospital.[Affiliation]"

Aims: The use of tolvaptan is increasing in clinical practice in Japan. However, the characteristics of patients who used tolvaptan and the timing of its use in patients with acute heart failure (AHF) are not fully elucidated.

Methods And Results: Among consecutive 4056 patients in the Kyoto Congestive Heart Failure registry, we analysed 3802 patients after excluding patients on dialysis, prior or unknown tolvaptan use at admission, and unknown timing of tolvaptan use, and we divided them into two groups: tolvaptan use (N = 773) and no tolvaptan use (N = 3029).

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The Impact of Mitral Regurgitation on Long-Term Outcomes in Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

Am J Cardiol

September 2023

Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan.

Article Synopsis
  • The study focused on the effects of mitral regurgitation (MR) on long-term health outcomes in acute myocardial infarction (AMI) patients who had a percutaneous coronary intervention (PCI).
  • In a cohort of 5,266 patients, those with more severe MR had higher rates of hospitalization for heart failure (HF), but their risk of all-cause and cardiovascular death did not significantly increase over time.
  • Although severity of MR did not correlate with increased mortality risk, both mild and moderate/severe MR were linked to significantly higher hospitalization rates for HF during a median follow-up of 5.6 years.
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Article Synopsis
  • * Among 10,822 patients, PC-AKI occurred significantly more in those undergoing emergent PCI (10.5%) compared to elective PCI (3.7%).
  • * Patients with PC-AKI had a higher risk of all-cause death, with the risk being greater for those who had emergent PCI, indicating the severity of PC-AKI's impact in urgent situations.
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Article Synopsis
  • The PACIFIC regimen, which involves durvalumab treatment after chemoradiation, is standard for unresectable stage III NSCLC, but many patients see disease progression within a year, highlighting a need to understand treatment resistance.
  • A study involving 135 patients aimed to analyze tumor microenvironments and immune cell profiles to identify resistance mechanisms, revealing key findings related to adaptive immunity and specific cancer cell behaviors.
  • Results showed that low levels of CD8 lymphocytes and high CD73 expression in tumors correlate with poor treatment outcomes, suggesting that targeting CD73 may improve future therapies and highlighting the role of adaptive immunity in treatment effectiveness.
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Background: Although many recent studies have scientifically verified the efficacy of the traditional herbal medicine daikenchuto (DKT) for postoperative gastrointestinal function, its efficacy has not been established in children. We retrospectively evaluated the effect of DKT in pediatric patients with panperitonitis associated with perforated appendicitis (PaPA) who underwent laparoscopic appendectomy.

Methods: Among 34 children with PaPA who underwent laparoscopic appendectomy from May 2012 to May 2021, 19 received DKT (group D) and 12 did not (group C).

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In-hospital outcomes after SAVR or TAVI in patients with severe aortic stenosis.

Cardiovasc Interv Ther

January 2024

Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

There were no data comparing the in-hospital outcomes after transcatheter aortic valve implantation (TAVI) with those after surgical aortic valve replacement (SAVR) in Japan. Among consecutive patients with severe AS between April 2018 and December 2020 in the CURRENT AS Registry-2, we identified 1714 patients who underwent aortic valve replacement (TAVI group: 1134 patients, and SAVR group: 580 patients). Patients in the TAVI group were much older (84.

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Objectives: This study aimed to compare the short and long-term outcomes of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and resection of isolated peritoneal metastases in patients with peritoneal metastases from colorectal cancer in Japan.

Methods: We included patients who had undergone surgery for peritoneal metastases from colorectal cancer between 2013 and 2019. Data were retrieved from a prospectively maintained multi-institutional database and retrospective chart review.

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Article Synopsis
  • This study investigates the link between tricuspid regurgitation (TR) and outcomes in patients with acute heart failure (AHF) using data from a large Japanese registry.
  • A total of 3,735 AHF patients were analyzed, revealing a direct correlation where increased severity of TR led to higher risks of all-cause mortality and hospital readmissions for heart failure.
  • Despite the high prevalence of moderate to severe TR, very few patients underwent surgical intervention, highlighting a potential gap in treatment options for these individuals.
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Association between changes in loop diuretic dose and outcomes in acute heart failure.

ESC Heart Fail

June 2023

Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Article Synopsis
  • The study examined the effects of starting or changing loop diuretics during acute heart failure (AHF) hospitalization on post-discharge outcomes, specifically all-cause mortality.
  • Analyzing data from 3665 patients, they found that starting loop diuretics during hospitalization did not lower the risk of death after discharge.
  • Additionally, altering the dose of loop diuretics for patients already on them had no significant impact on mortality risk, with higher doses possibly increasing the risk.
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  • The study investigates life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS), highlighting a lack of existing data on this topic.
  • Data from 3815 patients in the CURRENT AS registry revealed that those who underwent AVR had better survival rates than those using a conservative treatment strategy, especially among younger patients.
  • The findings suggest that assessing surgical risk based on age and STS score can help estimate life expectancy post-AVR, which is crucial for deciding between surgical and transcatheter approaches.
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Article Synopsis
  • Congestion significantly impacts hospitalization outcomes in heart failure patients, with higher levels correlating to increased risk of death or readmission.
  • A study of 3787 hospitalized heart failure patients in Japan revealed that those with higher Composite Congestion Scores (CCS) at admission were more likely to experience adverse outcomes.
  • Even after achieving complete decongestion prior to discharge, residual congestion still indicated a higher risk for post-discharge complications, emphasizing the importance of monitoring congestion levels throughout treatment.
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Background: The neutralizing ability of sotrovimab and casirivimab/imdevimab against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is attenuated in the subvariant BA.5. However, the efficacy of sotrovimab in the clinical setting remains to be investigated.

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High-grade fetal lung adenocarcinoma (H-FLAC) is a rare tumor, with little known of its response to chemotherapy with or without an immune checkpoint inhibitor or of its molecular profile. We report the first case of a 56-year-old man with stage IV H-FLAC who was successfully treated with carboplatin plus nab-paclitaxel in combination with atezolizumab. In addition, the tumor was found to be positive for amplification of the human epidermal growth factor receptor 2 gene.

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Background: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization.

Objectives: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive interventions.

Methods: The study population consisted of 39,427 patients (diabetes: n = 15,561; nondiabetes: n = 23,866) who underwent first percutaneous coronary intervention (n = 33,144) or coronary artery bypass graft (n = 6,283) in the pooled CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Graft) registry.

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Skeletal alterations in the head and neck region, such as midfacial hypoplasia, foramen magnum stenosis and spinal canal stenosis, are commonly observed in patients with mucopolysaccharidosis (MPS). However, enzyme replacement therapy (ERT), one of the major treatment approaches for MPS, shows limited efficacy for skeletal conditions. In this study, we analysed the craniofacial morphology of mice with MPS type VII, and investigated the underlying mechanisms promoting jaw deformities in these animals.

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April 2021 saw a widespread outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Osaka, Japan. We encountered the case of a 52-year-old man who had Guillain-Barré syndrome associated with coronavirus disease 2019 (COVID-19). After the relief of the respiratory symptoms owing to COVID-19, the patient experienced muscle weakness, which spread from his fingers to his extremities, and was unable to walk.

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Article Synopsis
  • - The study compares the long-term outcomes of percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES) and coronary artery bypass grafting (CABG) in 2,464 patients with multi-vessel coronary artery disease.
  • - Although the 5-year risk of combined events like death, heart attack, or stroke was not significantly different between the two groups, adjusted analysis showed that PCI had a higher risk of myocardial infarction and the need for additional revascularization compared to CABG.
  • - The findings suggest that while both procedures have similar outcomes regarding death and stroke, PCI with new-generation DES may carry a greater long-term risk for major cardiovascular issues in patients requiring complex multi-vessel treatments
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Recurrence patterns and progression-free survival after chemoradiotherapy with or without consolidation durvalumab for stage III non-small cell lung cancer.

J Radiat Res

January 2023

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Chemoradiotherapy followed by consolidation durvalumab (CCRT+D) improves survival in patients with stage III non-small-cell lung cancer (NSCLC). We compared recurrence patterns and survival in the CCRT+D and CCRT cohorts. We conducted a multicenter, retrospective study in Japan.

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Introduction: Pembrolizumab became available in Japan in February 2017 for first-line monotherapy of unresectable advanced and metastatic NSCLC with programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) greater than or equal to 50%. This retrospective chart review study aimed to describe real-world clinical outcomes of first-line pembrolizumab monotherapy, including for patients 75 years or older, who are under-represented in clinical trials.

Methods: We identified patients (≥20 y old) at 23 sites initiating first-line pembrolizumab monotherapy from July 1, 2017, to December 20, 2018, for stages IIIB, IIIC, and IV NSCLC with PD-L1 TPS greater than or equal to 50% and Eastern Cooperative Oncology Group performance status of 0 to 2 or unknown.

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Background: There has been no previous report evaluating the long impact of atrial fibrillation (AF) on the clinical outcomes stratified by the initial management [conservative or aortic valve replacement (AVR)] strategies of severe aortic stenosis (AS).

Methods: We analyzed 3815 patients with severe AS enrolled in the CURRENT AS registry. Patients with AF were defined as those having a history of AF when severe AS was found on the index echocardiography.

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Article Synopsis
  • The study investigates the relationship between the CHADS score and the long-term risk of ischemic stroke in patients with coronary artery disease (CAD), both with and without atrial fibrillation (AF).
  • It analyzes data from 11,516 CAD patients who underwent a specific heart procedure, showing that higher CHADS scores correlate with increased stroke risk: 2.1% to 17.1% in patients without AF and 4.2% to 40.7% in those with AF over five years.
  • The findings reveal that increased CHADS scores are linked to a higher likelihood of severe strokes, irrespective of the presence of AF, indicating the score’s relevance in assessing stroke risk in CAD patients.
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