138 results match your criteria: "Nippon Medical School Tokyo Japan.[Affiliation]"

Background And Aims: Hypertensive emergencies, characterized by elevated blood pressure (BP) and multiple organ damage, have poor prognosis. Patients occasionally show gradual improvement in renal function with appropriate antihypertensive treatment despite renal impairment. However, reports analyzing factors predicting prognosis in patients with hypertensive emergencies and severe renal impairment are limited.

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Purpose: This descriptive analysis evaluated the 2022 assisted reproductive technology (ART) data collected by the Japan Society of Obstetrics and Gynecology registry.

Methods And Results: In 2022 (cutoff date 30 November 2023), 634 of 635 registered ART facilities participated; 602 implemented ART treatment, with 543 630 registered cycles and 77 206 neonates (9.1% and 10.

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Background: Several conditions such as infertility, repeated implantation failure, and recurrent pregnancy loss can pose challenges in early pregnancy. These issues can be caused by the abnormal inflammatory response with various factors, including exogenous and endogenous agents, and pathogenic and nonpathogenic agents. In addition, they can be exacerbated by maternal immune response to the abovementioned factors.

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In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.

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Background: Although endovascular therapy (EVT) is effective for large ischemic region strokes, the impact of hyperglycemia remains unclear.

Methods And Results: We analyzed data from the RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism-Japan Large Ischemic Core) trial, which randomized stroke patients with Alberta Stroke Program Early Computed Tomography Score of 3 to 5 to EVT versus medical management. Outcomes were compared among patients with normoglycemia (<140 mg/dL), moderate hyperglycemia (≥140, <180 mg/dL), and severe hyperglycemia (≥180 mg/dL) on admission.

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Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.

Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.

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Article Synopsis
  • The Japanese Catheter Ablation (J-AB) registry, launched in August 2017, is a nationwide voluntary study led by the Japanese Heart Rhythm Society focused on collecting data about catheter ablation procedures.
  • In January 2022, the registry's data collection system shifted from REDCap to the Fountayn system to improve data management.
  • By the end of 2022, the registry compiled data from 90,042 procedures across 614 hospitals, highlighting the types of arrhythmias, outcomes, and complications, with participants averaging 66.7 years old and 65.9% being male.
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  • The study explores how regional factors affect participation in cardiac rehabilitation (CR) and includes a large cohort of 2.7 million inpatients in Japan from 2012 to 2021.
  • It categorizes hospitals into No-CR, High-CR, and Low-CR based on participation rates, finding that High-CR hospitals tend to have smaller service areas, more physicians per population, higher temperatures, and fewer primary industry workers.
  • Key regional characteristics influencing High-CR hospitals include a lower consumer price index and a tendency for a younger population, thus highlighting the importance of local economic and demographic factors in CR participation.
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  • - This study investigated the link between specific genetic variations (SNPs) related to chronic pancreatitis and clinical features of patients with intraductal papillary mucinous neoplasm (IPMN).
  • - A total of 100 patients with IPMN and 116 control patients were analyzed, measuring various serum enzyme levels and performing endosonography to evaluate the severity of the condition.
  • - Findings indicated that certain genotypes, particularly for carboxypeptidase A1 and gamma-glutamyltransferase 1, may help diagnose and predict concerning features of IPMN, such as cyst size.
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Objectives: Pancreatic fibrosis is one of the main pathological features of chronic pancreatitis (CP), suggesting a strong relationship between CP and pancreatic ductal cancer. There was no available data about pancreatic fibrosis and pancreatic dysfunction in the early CP (ECP) using endosonography (EUS).

Methods: Asymptomatic patients with pancreatic enzyme abnormalities (AP-P; = 56) and patients with ECP ( = 21) were determined by the absence of abnormal findings on upper gastrointestinal endoscopy, abdominal ultrasonography, and abdominal computed tomography.

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In pulmonary hypertension (PH) associated with chronic lung disease (CLD), identifying patients who would benefit from pulmonary vasodilators is a significant clinical challenge because the presence of PH is associated with poorer survival. This study evaluated the severity of pulmonary circulation impairment in patients with CLD-PH using pulmonary perfusion single-photon emission computed tomography/computed tomography (SPECT/CT). This single-center, observational study enrolled patients with CLD-PH who had a mean pulmonary arterial pressure (PAP) ≥ 25 mmHg, as confirmed by right heart catheterization.

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Mixed-phenotype acute leukemia (MPAL) with -TKD mutations is a rare and challenging subtype of leukemia. Effective management strategies are crucial for improving patient outcomes. A 31-year-old man with -TKD-mutated MPAL achieved hematological remission through the JALSG ALL202-O protocol and gilteritinib, followed by cord blood transplantation (CBT).

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Out-of-hospital cardiac arrest (OHCA) is a global public health problem, with survival rates remaining low at around 10% or less despite widespread cardiopulmonary resuscitation (CPR) training and availability of automated external defibrillators (AEDs). This is partly due to the challenges of knowing when and where a sudden OHCA occurs and where the nearest AED is located. In response, countries around the world have begun to use network technology-based smartphone applications.

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Article Synopsis
  • The All Nippon Atrial Fibrillation In the Elderly Registry studied over 30,000 elderly Japanese patients with non-valvular atrial fibrillation, focusing on outcomes based on age and type of oral anticoagulants (OACs).
  • Results showed that the incidence of stroke, major bleeding, and intracranial hemorrhage increased significantly with age, but plateaued for those aged 90 and over.
  • Direct OACs (DOACs) generally resulted in lower event rates compared to warfarin, particularly in patients aged 75-85 years, but had limited effectiveness in reducing major bleeding for patients aged 90 and older, suggesting very-low-dose DOACs might be beneficial for this older
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Background: Cardioprotective drugs have not been previously shown to improve the prognosis in patients with fulminant myocarditis presentation (FMP). We aimed to investigate whether cardioprotective drugs, including angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) and β-blocker, administered during hospitalization improved the prognosis in patients with FMP.

Methods And Results: This multicenter cohort study conducted in Japan included 755 patients with clinically diagnosed FMP.

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  • * A total of 189 patients who underwent total mesorectal excision and LLND were included, and data on local recurrence (LR) and lateral lymph node recurrence (LLNR) were analyzed after matching similar patient characteristics.
  • * While 39 patients had pathological LLNM, the analysis showed similar rates of LR and LLNR in both groups after balancing their characteristics, suggesting LLND can provide comparable local control regardless of LLNM presence.
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Background: Despite the positive impact of implantable cardioverter defibrillators (ICDs) and wearable cardioverter defibrillators (WCDs) on prognosis, their implantation is often withheld especially in Japanese heart failure patients with reduced left ventricular ejection fraction (HFrEF) who have not experienced ventricular tachycardia (VT) or ventricular fibrillation (VF) for uncertain reasons. Recent advancements in heart failure (HF) medications have significantly improved the prognosis for HFrEF. Given this context, a critical reassessment of the treatment and prognosis of ICDs and WCDs is essential, as it has the potential to reshape awareness and treatment strategies for these patients.

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Guidance for clinical practice using emergency and point-of-care ultrasonography.

Acute Med Surg

June 2024

Committee for the Promotion of Point-of-Care Ultrasonography Japanese Association for Acute Medicine Japan.

Article Synopsis
  • The miniaturization of ultrasound scanners has led to the rise of point-of-care ultrasonography (POCUS), allowing bedside use for quick clinical decision-making, especially in emergencies.
  • In Japan, while POCUS is becoming more recognized globally, formal guidance was previously limited to trauma assessments and central venous procedures.
  • The Japanese Association for Acute Medicine has now established comprehensive clinical guidance for POCUS, addressing its principles and applications in emergency care, which aims to enhance ultrasound education and the quality of acute medical services in Japan.
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Background: Some patients are reported to develop depression immediately after COVID-19 infection. Typically, hospitalization is arranged a week to 10 days after symptom onset to avoid outbreak in the psychiatric ward when infectivity is almost eliminated. However, in patients on immunosuppressive drugs, infection is known to persist beyond the 10th day after testing positive with a polymerase chain reaction (PCR) test.

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Background: Anemia has negative effects on long-term outcomes of rectal cancer patients; however, its status as a risk factor for severe complications is disputed. Perioperative risks may differ based on the severity of pre-surgical anemia; nonetheless, no previous study has investigated these differences. This study identified risks of severe postoperative complications in rectal cancer patients based on severity of their pre-surgical anemia.

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  • The review assessed how socioeconomic status (SES) impacts recovery outcomes for stroke patients, analyzing various indicators like education, income, and neighborhood wealth.
  • After reviewing 19 studies involving over 157,000 patients, the findings showed that lower SES is significantly linked to worse functional outcomes post-stroke.
  • The study highlights the persistent influence of social disadvantage on stroke recovery and calls for more research to explore underlying reasons for these disparities.
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  • * Studies show that while women may respond differently to antiplatelet therapy, no significant differences were found in bleeding risks during the chronic phase post-PCI; however, factors like age and weight must be considered for dosage.
  • * There is unclear evidence regarding the effectiveness and safety of different antithrombotic therapies for women post-PCI, especially concerning anticoagulants and triple therapy, highlighting a need for more research in this area for better treatment guidelines.
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  • The study explores how treating the left ventricle with Lugol's solution affects heart function in dogs with heart attack-induced ischemia, focusing on ventricular fibrillation, a major cause of death.
  • Researchers found that chemical ablation with Lugol's solution raised the threshold for induced ventricular fibrillation compared to normal saline treatment, suggesting a protective effect on the heart.
  • Histological results indicated damage to the heart's conduction system and abnormal conduction patterns, but the approach shows potential for treating severe heart rhythm problems in acute myocardial ischemia cases.
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