34 results match your criteria: "Oita Medical Center[Affiliation]"

A systematic review of factors associated with poor prognosis despite appropriate antibiotics usage for pneumonia.

Respir Investig

November 2024

Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan. Electronic address:

Article Synopsis
  • Treatment with appropriate antibiotics does not significantly improve prognosis in elderly pneumonia patients, indicating a need to identify factors linked to poor outcomes.
  • A systematic review analyzed studies to find risk factors that could suggest when not to pursue aggressive antibiotic treatment.
  • The review found that advanced age and high severity scores are primary factors associated with increased mortality, suggesting that broad-spectrum antibiotics might be unnecessary for certain elderly patients.
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  • A study investigated the effects of high-risk coronary artery plaques on late luminal narrowing and clinical events in patients after percutaneous coronary intervention.
  • Over one year, the coronary artery lumen area decreased notably, especially in specific types of plaques, such as thin-cap and thick-cap fibroatheromas.
  • Thin-cap fibroatheroma presence was linked to a higher risk of needing further revascularization procedures after ischemia, while no significant connection was found between coronary artery calcium levels and clinical outcomes within three years.
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  • EUS-guided biliary drainage (EUS-BD) has shown good results in high-volume centers, but this study investigates its safety and effectiveness in newer centers that recently adopted the procedure.
  • The research involved 22 centers from 2017 to 2022, assessing 255 patients and looking at the success and complications of EUS-BD performed by 84 endoscopists.
  • The study found a high technical success rate of 91.4% but identified specific risks for failure and complications, including smaller puncture target diameters and moderate ascites, highlighting that the experience level of endoscopists did not significantly affect outcomes.
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Background/aim: Adjuvant therapy using third-generation tyrosine kinase inhibitors (TKI) demonstrated improved central nervous system (CNS) disease-free survival after surgery in patients with epidermal growth factor receptor (EGFR) mutation-positive lung cancer. However, the prognostic impact of CNS recurrence in surgical patients remains unknown. We evaluated the effect of CNS recurrence on post-recurrence survival (PRS) in patients with postoperatively recurrent NSCLC.

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  • EUS-BD (endoscopic ultrasound-guided biliary drainage) is now seen as a top choice for certain biliary obstructions, similar to retrograde cholangiopancreatography.
  • The study analyzed various experience-related factors at beginner hospitals to assess their impact on EUS-BD outcomes, comparing successful cases to those that failed.
  • Key findings indicated that meeting certain experience thresholds for institutions and operators (like a minimum number of procedures performed) was linked to better success rates in EUS-BD interventions.
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  • This study compares the effectiveness and safety of Atezolizumab plus Bevacizumab (ATEZO/BEVA) versus Lenvatinib (LEN) as first-line treatments for hepatocellular carcinoma (HCC).
  • A total of 810 patients were analyzed, and after matching for comparable characteristics, the results showed no significant difference in objective response rates (44.8% for ATEZO/BEVA vs. 46.7% for LEN), but ATEZO/BEVA had better progression-free survival and overall survival rates.
  • ATEZO/BEVA also had lower rates of severe side effects like appetite loss and fatigue, but a higher rate of severe bleeding, and showed a better conversion
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Early detection of pancreatic ductal adenocarcinoma (PDAC) in the general population is difficult due to unknown clinical characteristics. This study was conducted to clarify the factors associated with early stage PDAC. Well-known symptoms and factors associated with PDAC were classified into clinical indicators, risk factors, and imaging findings concomitant with early stage PDAC.

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  • The study analyzed 20,547 cases of hepatocellular carcinoma (HCC) over 24 years, focusing on trends in sex, age, and disease causes, divided into four 6-year periods.
  • The data revealed that a significant majority (68.2%) of HCC patients were male, with the average age of newly-diagnosed patients increasing over time, particularly in the elderly population.
  • HCC cases associated with hepatitis C virus (HCV) declined, while cases with non-B viral causes and hepatitis B virus (HBV) infections rose, indicating a shift in the epidemiological profile of HCC patients.
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  • This study aimed to update the prognosis of cirrhosis and identify risk factors for death, despite advancements in liver disease management.
  • The research analyzed data from 444 patients across 25 hospitals, observing survival rates based on Child-Pugh classification and albumin-bilirubin grades, highlighting that prognosis remains poor, especially for those with Child-Pugh class C cirrhosis.
  • Key risk factors for increased mortality included cirrhosis classification, age, liver cancer, and untreated esophageal varices, with no significant improvement in prognosis over previous studies.
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Background: Laparoscopic surgical approaches, including total extraperitoneal repair (TEP), have been widely accepted for inguinal hernia repair in Japan. However, there are limited data regarding recurrence after TEP in Japan, given the limited versatility of this procedure. This study retrospectively evaluated the rates of hernia recurrence after TEP and open mesh repair at multiple Japanese centers.

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Background: Skeletal muscle metastasis from gastric cancer is rare and has a poor prognosis. We reported a case of gluteal muscle metastasis with peritoneal dissemination from gastric cancer during postoperative adjuvant chemotherapy.

Case Presentation: A 64-year-old man with gastric cancer underwent distal gastrectomy with D2 lymph node resection.

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Article Synopsis
  • Poor preoperative nutritional and immunological status, measured by the Prognostic Nutrition Index (PNI), increases the risk of postoperative complications in patients with hepatocellular carcinoma (HCC) after surgery.
  • A study of 510 patients found that those with lower PNIs experienced significantly more complications than those with higher PNIs, indicating that a PNI below 45 is a strong predictor of adverse outcomes.
  • The research suggests that combining the PNI with the type of surgical procedure (major or minor hepatectomy) can improve predictions for postoperative complications, highlighting the importance of preoperative assessments.
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Rectal varix treated with endoscopic cyanoacrylate injection therapy.

Clin J Gastroenterol

June 2021

Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.

There is no established treatment for rectal varices. Although endoscopic cyanoacrylate (N-butyl 2-cyanoacrylate) injection therapy is the standard treatment for gastric varices, there are few reports of its use for rectal varices. We present a case of rectal varix that was successfully treated with endoscopic cyanoacrylate injection therapy.

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Background: A previous Phase I/II study demonstrated that TAS-102 (trifluridine/tipiracil [FTD/TPI]) plus bevacizumab (Bev) has encouraging efficacy and controllable safety for patients with previously treated metastatic colorectal cancer. Therefore, we designed for assessing the efficacy and safety of FTD/TPI plus Bev in elderly patients with previously untreated metastatic colorectal cancer.

Methods: This is a multicenter, single-arm Phase II study included patients ≥70 years old with previously untreated, unresectable metastatic colorectal cancer.

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A 61-year-old man underwent CapeOX plus bevacizumab chemotherapyafter right hemicolectomyfor metastatic ascending colon cancer. On the 7th dayafter the first administration, he had sudden abdominal pain and nausea. Contrast-enhanced computed tomographyrevealed aortic thrombosis and a superior mesenteric artery(SMA)embolism that was considered to be associated with bevacizumab.

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Introduction: Tadalafil improves lower urinary tract symptoms (LUTS) including nocturia. However, the effect of tadalafil on the nocturia-related quality of life (QoL) is still unknown.

Objective: The effects of tadalafil on nocturia and nocturia-related QoL were evaluated prospectively in patients with benign prostatic hyperplasia (BPH) as a multicenter study.

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Objectives: This study aimed to evaluate the long-term outcomes of neoadjuvant chemoradiotherapy with S-1 in patients with locally advanced rectal cancer.

Methods: A multi-institutional, prospective, phase II trial was conducted between April 2009 and August 2011. The study enrolled 37 patients with histologically proven rectal carcinoma (T3-4 N0-3 M0) who underwent neoadjuvant chemoradiotherapy with S-1.

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Background: Brain metastasis from undifferentiated pleomorphic sarcoma (UPS) is a rare occurrence, and its clinical course is little known. In this report, we investigate a case of a rapidly growing brain metastasis from gastric UPS.

Case Description: An 82-year-old man with a known gastric tumor, pathologically compatible with UPS, underwent partial gastrectomy at an outside facility.

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Article Synopsis
  • This study aimed to determine the effect of long-term clarithromycin therapy on preventing pneumonia in older adults who had recently recovered from the illness.
  • A randomized, controlled trial was conducted with participants aged 65+ years, comparing a low-dose clarithromycin group to a control group.
  • Results showed no significant differences in pneumonia recurrence rates or time to recurrence between the two groups, suggesting that further large-scale studies are needed to explore this treatment option.
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Background: Both contact force monitoring (CFM) and unipolar signal modification (USM) are guides for ablation, which improve the efficacy of pulmonary vein isolation of atrial fibrillation. We sought to compare the outcomes of atrial fibrillation ablation guided by CFM or USM.

Methods: A total of 136 patients with paroxysmal atrial fibrillation underwent a circumferential pulmonary vein isolation using CF sensing ablation catheters and were randomly assigned to undergo catheter ablation guided by either CFM (CFM-guided group: n=70) or USM (USM-guided group: n=66).

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Objectives: Platinum-based combination chemotherapy is the standard postoperative adjuvant treatment for pathological stage II/III non-small cell lung cancer (NSCLC). Oral S-1 therapy has good efficacy and relatively low toxicity for the treatment of advanced NSCLC. We investigated whether long-term S-1 monotherapy is also useful as an adjuvant therapy after surgery in patients with NSCLC.

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Background: Bone and soft tissue sarcomas are commonly treated with consecutive-day chemotherapy regimens consisting of multiple anticancer agents. Chemotherapy-induced nausea and vomiting (CINV) is a serious adverse effect of these regimens and may result in decreased energy intake during chemotherapy. Decreased energy intake may lead to undernutrition and may cause adverse effects on patient quality of life and survival.

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Background: We aimed to clarify renal functional changes long term and serious urological complications in women with cervical cancer who undergo radical hysterectomy followed by pelvic radiotherapy and/or platinum-based chemotherapy to treat the initial disease.

Methods: Data on 380 women who underwent radical hysterectomy at the National Kyushu Cancer Center from January 1997 to December 2013 were reviewed. Main outcome measures were the estimated glomerular filtration rate (eGFR) and monitored abnormal urological findings.

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Aims: PCR-Invader is a highly sensitive assay for detecting non-structural protein 5A (NS5A) resistance-associated variants (RAVs) of hepatitis C virus (HCV). Here, we validated the accuracy of the semiquantitative PCR-Invader (SQ-PI) assay compared to direct sequencing (DS) for identifying NS5A RAVs, and we evaluated the treatment efficacy of daclatasvir plus asunaprevir (DCV + ASV) for patients judged to be non-positive for NS5A RAVs by SQ-PI.

Methods: Detection rates of NS5A RAVs by SQ-PI and DS were compared for 204 patients with HCV genotype 1b.

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Background: As the toxicity associated with the α-GalCer-pulsed dendritic cell (DC) therapy could be considered to be negligible, its addition to postoperative adjuvant chemotherapy would be expected to greatly improve the therapeutic effect, and could result in prolonged survival. The aim of the present study is to compare the therapeutic efficacy of alpha-galactosylceramide-pulsed DC therapy in patients who have undergone a complete resection of stage II-IIIA non-small-cell lung cancer (NSCLC) followed by postoperative adjuvant therapy with cisplatin plus vinorelbine, to that in patients who did not receive additional treatment (surgical resection plus postoperative adjuvant chemotherapy only).

Methods: Subsequent to the complete resection of NSCLC, followed by the administration of cisplatin plus vinorelbine dual-agent combination adjuvant chemotherapy, patients who satisfy the inclusion criteria will be randomly allocated to either the α-GalCer-pulsed DC immune therapy group, or the standard treatment group.

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