Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio.

Elevated Fulminant Index (FI), [plasma glucose (PG)/glycosylated hemoglobin A1c (HbA1c)], was reportedly a sensitive index to differentiate fulminant type 1 diabetes (FT1D) from non-fulminant T1D (nFT1D). Aim of this study was to describe a better, but simpler index of FT1D. 49 and 52 patients with FT1D and nFT1D, respectively, were registered, and the discriminating ability of the rounded, normalized ratio, [PG (mmol/L) - 5.

Observational study on the identification of left atrial tachycardia circuits using Local Activation Time Histogram.

Background: Mapping of atypical atrial arrythmias arising in the left atrium is often challenging. The Local Activation Time (LAT) Histogram, a new function of the 3D color mapping system CARTO version 7, may help improve identification of atrial tachycardia circuits. We aimed to assess the effectiveness of the LAT Histogram for identification of left atrial tachycardia circuits.

Longitudinal Changes in Diagnostic Accuracy of a Differential Diagnosis List Developed by an AI-Based Symptom Checker: Retrospective Observational Study.

Background: Artificial intelligence (AI) symptom checker models should be trained using real-world patient data to improve their diagnostic accuracy. Given that AI-based symptom checkers are currently used in clinical practice, their performance should improve over time. However, longitudinal evaluations of the diagnostic accuracy of these symptom checkers are limited.

Safety and Effectiveness of Exercise-Based Cardiac Rehabilitation for Patients With Atrial Fibrillation Following Radiofrequency Catheter Ablation Therapy: A Systematic Review and Meta-Analysis.

Despite the potential of cardiac rehabilitation (CR) to reduce atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA), its prescription is not routine. We conducted a systematic review and meta-analysis to evaluate the safety and efficacy of CR in this setting. Inclusion criteria comprised randomized controlled trials (RCTs) comparing CR with usual care in patients with AF following RFCA.

Balloon surface temperature-controlled ablation using a second-generation radiofrequency HotBalloon: an in vivo feasibility study.

Aims: The first-generation radiofrequency HotBalloon (RHB) is a size-adjustable single-shot device used in atrial fibrillation. The energy output is determined by its central temperature and not by its balloon surface temperature (BST), thus limiting its efficacy and safety. Therefore, a second-generation RHB was developed to monitor BST and enable BST-controlled ablation.

Effects of Combinational Use of Additional Differential Diagnostic Generators on the Diagnostic Accuracy of the Differential Diagnosis List Developed by an Artificial Intelligence-Driven Automated History-Taking System: Pilot Cross-Sectional Study.

Background: Low diagnostic accuracy is a major concern in automated medical history-taking systems with differential diagnosis (DDx) generators. Extending the concept of collective intelligence to the field of DDx generators such that the accuracy of judgment becomes higher when accepting an integrated diagnosis list from multiple people than when accepting a diagnosis list from a single person may be a possible solution.

Objective: The purpose of this study is to assess whether the combined use of several DDx generators improves the diagnostic accuracy of DDx lists.

Pericarditis due to Campylobacter coli infection: a case report.

Campylobacter spp. is a gram-negative bacillus that causes infectious enteritis and consists of several species, including Campylobacter jejuni, Campylobacter coli, and Campylobacter fetus. Although C.

Molecular Confirmation of an Indole-Negative Klebsiella oxytoca Isolated from a Patient with Cystitis.

Klebsiella oxytoca is an opportunistic pathogen that causes nosocomial infections. Here, we describe an unusual clinical strain of indole-negative K. oxytoca, GU175, isolated from the urine of a patient with cystitis.

HotBalloon Pulmonary Vein Isolation Registry Study - Real-World Efficacy and Safety of HotBalloon Ablation.

Background: Radiofrequency hotballoon (RHB) is an ablation device used for atrial fibrillation (AF) treatment. The efficacy and safety of RHB-based pulmonary vein isolation (PVI) in real-world practice are unknown.

Methods and results: A multicenter, prospective registry study (UMIN000029567) enrolled AF patients who underwent RHB-PVI.

Development and practical evaluation of a saturation effect learning simulator for inflow magnetic resonance angiography.

The quality of visualization in inflow magnetic resonance angiography (MRA) depends highly on the excitation state of the longitudinal magnetization obtained using specified imaging parameters. In addition, signal intensity changes controlled by the preparation pulse-such as inversion recovery (IR) and saturation recovery (SR)-can potentially be used as quantitative physiological values. Although having practitioners understand these relationships both qualitatively and quantitatively is important, handling clinical equipment in practical learning or experiments involves limited opportunities.

An autopsy case of Parkes-Weber syndrome with high-output heart failure: Hemodynamic alterations following treatment for arteriovenous fistulas.

Unlabelled: An autopsy case of Parkes-Weber syndrome presenting high-output heart failure in a patient who died at 52 years old, is reported. The patient had a tumor in the right buttock since childhood, that had grown up to a diameter of 40 cm diameter by the age of 43 years when he felt exertional dyspnea and was diagnosed as having high-output heart failure due to arteriovenous fistulas. Embolotherapy was attempted, which relieved the symptoms.

Impact of Flood Due to Typhoon Hagibis on Cardiovascular and Cerebrovascular Events in the Disaster Area of Nagano City: A Sub-Analysis Using Data From the SAVE Trial.

Objectives: This study aimed to examine the effects of flooding due to Typhoon Hagibis on the incidence of cardiovascular/cerebrovascular events in Nagano City.

Methods: The SAVE trial retrospectively enrolled 2426 patients hospitalized for cardiovascular/cerebrovascular disease in 5 hospitals in Nagano City from October 1 to December 31 in 2017 and 2018 (pre-disaster period) and in 2019 (post-disaster period). From these, 280 patients who were hospitalized in a district flooded in 2019 were recruited for the same period (October 12 to December 31) over the 3 years.

[Delayed Hemolytic Transfusion Reaction after Mitral Valve Replacement:Report of a Case].

We report a case of delayed hemolytic transfusion reaction (DHTR) after mitral valve replacement (MVR). A 67-year-old woman with a history of blood transfusion( BT) was admitted for MVR. Preoperative laboratory test proved to be negative for irregular antibodies except anti-Dia.

Incidence of Diagnostic Errors Among Unexpectedly Hospitalized Patients Using an Automated Medical History-Taking System With a Differential Diagnosis Generator: Retrospective Observational Study.

Background: Automated medical history-taking systems that generate differential diagnosis lists have been suggested to contribute to improved diagnostic accuracy. However, the effect of these systems on diagnostic errors in clinical practice remains unknown.

Objective: This study aimed to assess the incidence of diagnostic errors in an outpatient department, where an artificial intelligence (AI)-driven automated medical history-taking system that generates differential diagnosis lists was implemented in clinical practice.

Misdiagnosis of Rectus Abdominis Abscess Owing to Delayed Contrast-Enhanced Computed Tomography.

Unlabelled: A 77-year-old man, who was on anticoagulation, presented with a painful lump on the right abdominal wall. Laboratory tests showed slight anaemia and elevated inflammatory markers. Abdominal plain computed tomography (CT) revealed a mass in the right rectus abdominis muscle.

Severe Hypoxemia Caused by High-Output Heart Failure and Pulmonary Arteriovenous Malformations in Hereditary Hemorrhagic Telangiectasia.

A man affected by hereditary hemorrhagic telangiectasia who had chronic severe hypoxemia is presented. This hypoxemia was synergistically caused by high-output heart failure due to severe hepatic shunts and multiple pulmonary arteriovenous shunts. The symptomatic combination is rare, and genetic testing showed a novel endoglin mutation.

Clinical and molecular features of 66 patients with musculocontractural Ehlers-Danlos syndrome caused by pathogenic variants in (mcEDS-).

Background: Musculocontractural Ehlers-Danlos syndrome is caused by biallelic loss-of-function variants in (mcEDS-) or (mcEDS-). Although 48 patients in 33 families with mcEDS- have been reported, the spectrum of pathogenic variants, accurate prevalence of various manifestations and detailed natural history have not been systematically investigated.

Methods: We collected detailed and comprehensive clinical and molecular information regarding previously reported and newly identified patients with mcEDS- through international collaborations.

Massive hemorrhage from the posterior intercostal artery following lower partial sternotomy.

Background: Median sternotomy remains the most common approach in cardiovascular surgery. Recently, minimally invasive procedures, such as minimally invasive cardiac surgery, robot surgery, and catheter therapy have been developed in cardiovascular surgery. However, all these surgeries cannot be performed by minimally invasive approaches.

[Two cases of chronic upside down stomach with "reverse incarceration" in the abdominal cavity].

Upside down stomach (UDS) is a rare type of hiatal hernia. It is categorized by herniation of either the entire stomach or most of the gastric portion of the stomach into the posterior mediastinum. Acute UDS usually presents with abdominal and thoracic symptoms immediately after the stomach rotates, while chronic UDS often has either mild or no symptoms with the entire stomach rotated in the mediastinum.

aMAP score prediction of hepatocellular carcinoma occurrence and incidence-free rate after a sustained virologic response in chronic hepatitis C.

Aims: Hepatocellular carcinoma (HCC) can still occur in hepatitis C virus (HCV) patients who have achieved a sustained virologic response (SVR), which remains an important clinical issue in the direct-acting antivirals era. The current study investigated the clinical utility of the aMAP score (consisting of age, male, albumin-bilirubin, and platelets) for predicting HCC occurrence in HCV patients achieving an SVR by direct-acting antivirals.

Methods: A total of 1113 HCV patients without HCC history, all of whom achieved an SVR, were enrolled for clinical comparisons.

Effects of a Differential Diagnosis List of Artificial Intelligence on Differential Diagnoses by Physicians: An Exploratory Analysis of Data from a Randomized Controlled Study.

A diagnostic decision support system (DDSS) is expected to reduce diagnostic errors. However, its effect on physicians' diagnostic decisions remains unclear. Our study aimed to assess the prevalence of diagnoses from artificial intelligence (AI) in physicians' differential diagnoses when using AI-driven DDSS that generates a differential diagnosis from the information entered by the patient before the clinical encounter on physicians' differential diagnoses.

Efficacy of Artificial-Intelligence-Driven Differential-Diagnosis List on the Diagnostic Accuracy of Physicians: An Open-Label Randomized Controlled Study.

Background: The efficacy of artificial intelligence (AI)-driven automated medical-history-taking systems with AI-driven differential-diagnosis lists on physicians' diagnostic accuracy was shown. However, considering the negative effects of AI-driven differential-diagnosis lists such as omission (physicians reject a correct diagnosis suggested by AI) and commission (physicians accept an incorrect diagnosis suggested by AI) errors, the efficacy of AI-driven automated medical-history-taking systems without AI-driven differential-diagnosis lists on physicians' diagnostic accuracy should be evaluated.

Objective: The present study was conducted to evaluate the efficacy of AI-driven automated medical-history-taking systems with or without AI-driven differential-diagnosis lists on physicians' diagnostic accuracy.

[A case of early syphilitic hepatitis with jaundice cured by high-dose amoxicillin and probenecid].

A 44-year-old man was admitted because of general malaise, jaundice, and epigastric pain. The patient had no significant medical history. However, the patient visited a brothel 3 months ago and noticed initial induration on his penis 2 months ago.

Impact of a Commercial Artificial Intelligence-Driven Patient Self-Assessment Solution on Waiting Times at General Internal Medicine Outpatient Departments: Retrospective Study.

Background: Patient waiting time at outpatient departments is directly related to patient satisfaction and quality of care, particularly in patients visiting the general internal medicine outpatient departments for the first time. Moreover, reducing wait time from arrival in the clinic to the initiation of an examination is key to reducing patients' anxiety. The use of automated medical history-taking systems in general internal medicine outpatient departments is a promising strategy to reduce waiting times.