171 results match your criteria: "Omihachiman Community Medical Center[Affiliation]"

Introduction: Studies have reported the feasibility of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in elderly people with respect to both short- and long-term outcomes. As the elderly population in society increases, the requirement for managing super-elderly patients aged ≥85 years with EGC will also increase. This study aims to identify the long-term clinical outcomes of ESD for clinical T1N0 EGC in patients aged ≥85 years.

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  • A 72-year-old man on hemodialysis for diabetic nephropathy developed fever and penile pain, and his condition quickly worsened.
  • Despite a normal physical exam, he presented with penile necrosis by the end of the day and died the following morning.
  • Blood cultures detected Group G Streptococcus, confirming streptococcal toxic shock syndrome (STSS), indicating that hemodialysis patients with vascular calcification are at risk for significant organ damage, even without calciphylaxis.
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We assessed an 81-year-old woman who underwent laparoscopic distal pancreatectomy for a large branched-type intraductal papillary mucinous neoplasm. An enlarged and infected 60-mm cyst was found adjacent to the resection margin one month after surgery. The non-absorbable polymer clip (NAPC: Hem-o-Lok), which was used for ligation of the splenic artery, could also be visualized.

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  • - The study analyzed real-world data on extracorporeal cardiopulmonary resuscitation (ECPR) for patients experiencing out-of-hospital cardiac arrest (OHCA) in Japan from 2013 to 2018, focusing on neurological outcomes and complications.
  • - Among 1,644 patients, only 14.1% had favorable neurological outcomes at hospital discharge, and the survival rate was 27.2%, with initial shockable rhythms correlating with better outcomes.
  • - Complications were reported in 32.7% of patients during ECPR, with bleeding being the most common issue, affecting 16.4% at the cannulation site and 8.5% elsewhere. *
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Dietary folic acid augmentation during gestation reduces neurodevelopmental disorder risk in offspring; however, it is still unclear if excessive maternal folic acid intake can impair brain function in offspring. We examined if excessive folic acid intake throughout gestation altered the behavior of male offspring under poor nutrition during early gestation (E5.5-E11.

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Fetal growth restriction (FGR) is defined as fetuses who have failed to achieve a normal weight for gestational age. FGR is associated with adverse perinatal outcomes, including stillbirth. Pregnant women often perceive decreased fetal movements before intrauterine fetal death.

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An 86-year-old female was admitted to our hospital with acute progressive gait disturbance and cognitive impairment. Brain MR diffusion weighted imaging revealed abnormal high signal intensities in the bilateral hemispheres, dominantly in the frontal lobe. We first suspected acute encephalopathy due to Creutzfeldt-Jakob disease (CJD) from her clinical information.

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Carfilzomib (CFZ) constitutes powerful combinatory therapy for relapsed/refractory multiple myeloma (RRMM); however, cardiovascular adverse events (CVAEs) have been shown as major treatment obstacles with the use of CFZ. Along with our multi-institutional prospective observational study by the Kyoto Clinical Hematology Study Group on the efficacy and safety of CFZ-based treatments (UMIN000025108), we here performed an ad hoc analysis of CFZ-related CVAEs in 50 patients with RRMM. We analyzed the association between CFZ-related CVAEs and pre-planned examinations, including patients' background, electrocardiographic findings, echocardiographic findings, and serum/plasma levels of 18 potential candidate biomarkers.

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  • The study analyzes data from 50 patients with relapsed/refractory multiple myeloma to understand how frailty, poor performance status, and advanced age affect treatment outcomes and side effects of carfilzomib therapy.
  • It found that while overall response rates were not significantly impacted by these vulnerability criteria, frailty and advanced age led to shorter progression-free survival, indicating these factors influence how long patients remain stable.
  • Additionally, patients meeting these criteria experienced more severe hematologic adverse events, indicating a need for careful management and tailored assessments in vulnerable populations.
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Vitamin deficiency is rare in modern industrialised countries; however, it still occurs in patients with specific backgrounds, such as those with extremely unbalanced diets, those with alcoholism and those who have undergone gastrointestinal surgery. Imaging examinations that demonstrate classic findings confirm the clinical diagnosis of vitamin deficiency and help monitor response to treatment. Because vitamin deficiencies are not prevalent, the diagnosis might not be straightforward.

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Labial adhesion is characterised by complete or partial fusion of the labia minora. It occurs rarely in postmenopausal women. Although various methods have been proposed, there is no established treatment for postmenopausal patients with labial adhesions due to its low prevalence in this age group.

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Several trials have shown that paclitaxel drug-coated balloons (DCBs) significantly reduce restenosis rates. However, some reports have shown distal embolisms occurring after DCBs. No study has analyzed the clinical outcomes of patients with DCB-induced distal embolism.

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The etiology of central diabetes insipidus (DI) is classified into (1) idiopathic, (2) familial, and (3) secondary. Of these, familial central diabetes insipidus shows an autosomal dominant inheritance. We herein report a case in which this disease was diagnosed based on a family history of nocturnal enuresis.

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Background: In all the prefectures of Japan, with the exception of Shiga Prefecture, more than half of local governments have an organized prostate-specific antigen (PSA) screening system in place. However, in the Shiga Prefecture, only a single city performed PSA screening over the time period of this survey. The purpose of the present study was to determine the clinical, pathological, and therapeutic features of newly diagnosed prostate cancer in localities where a formally organized screening system was almost entirely absent.

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Optimal Sampling Strategy and Threshold of Serum Vancomycin Concentration in Elderly Japanese Patients Undergoing High-Flux Hemodialysis.

Ther Drug Monit

June 2022

Department of Pharmacy, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan. Dr. Terada is now with the Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.

Background: The optimal sampling points and thresholds for initial serum vancomycin (VCM) concentrations have not been determined in hemodialysis (HD) patients. To clarify this, multiple blood tests were performed, and the correlations between VCM concentrations at several sampling points and the area under the concentration-time curve for 24 hours (AUC24h) were analyzed.

Methods: A single-center, prospective observational study was conducted.

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  • Recent advancements in magnifying endoscopy, especially using narrow-band and blue laser imaging, have improved the diagnosis of gastrointestinal lesions.
  • Understanding the link between magnifying endoscopic images and histopathology is crucial for accurate diagnosis.
  • The proposed KOTO method II allows for a detailed three-dimensional visualization of the relationship between endoscopic surface patterns and histopathological images, potentially enhancing diagnostic capabilities.
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Background: The relationship between the timing of the first early recurrence and late recurrence after a single catheter ablation procedure for atrial fibrillation is controversial.

Methods: The Efficacy of Short-Term Use of Antiarrhythmic Drugs After Catheter Ablation for Atrial Fibrillation trial followed 2038 patients who underwent radiofrequency catheter ablation for atrial fibrillation.

Results: Of the patients, 907 (45%) had early recurrences within 90 days after the initial ablation.

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Background: Combinatory strategies with carfilzomib (CFZ), a second-generation proteasome inhibitor, plus dexamethasone (DEX) with or without lenalidomide (LEN) have shown promising efficacy for patients with relapsed/refractory multiple myeloma (RRMM) in pivotal clinical trials. However, their effects on patients who were resistance to bortezomib (BTZ) and/or LEN have not been fully evaluated in a daily practice setting.

Aims: To evaluate the real-world efficacy and safety of CFZ-based treatments; that is, CFZ with LEN plus DEX (KRD therapy) and CFZ with DEX (KD therapy), in Asian patients, we conducted a multicenter pilot prospective observational study in the Kyoto Clinical Hematology Study Group.

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Aim: A lack of known guidelines for the provision of extracorporeal cardiopulmonary resuscitation (ECPR) to patients with out-of-hospital cardiac arrest (OHCA) has led to variability in practice between hospitals even in the same country. Because variability in ECPR practice has not been completely examined, we aimed to describe the variability in ECPR practice in patients with OHCA from the emergency department (ED) to the intensive care units (ICU).

Methods: An anonymous online questionnaire to examine variability in ECPR practice was completed in January 2020 by 36 medical institutions who participated in the SAVE-J II study.

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  • - The study evaluated the impact of high bleeding risk (HBR) on adverse events in patients after percutaneous coronary intervention (PCI), analyzing data from 1,695 patients involved in the MODEL U-SES study in Japan.
  • - Patients were divided into HBR and Non-HBR groups, and after one year, the research found that HBR patients had a significantly higher incidence of ischemic/thrombotic events, but the difference in bleeding events between the two groups was not statistically significant.
  • - The conclusion highlighted that about half of the PCI patients were categorized as HBR, which raised the likelihood of ischemic/thrombotic events, while both aspirin and P2Y inhibitor monotherapy after dual antipl
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