344 results match your criteria: "Saiseikai Wakayama Hospital; Japan.[Affiliation]"

Background: This study aimed to compare the economic value of intermittent-scanning continuous glucose monitoring (isCGM) with self-monitoring of blood glucose (SMBG) in adults with type 1 diabetes (T1D).

Methods: Participants were placed on either an isCGM or SMBG arm for 84 days, in a randomized, crossover setup with a 28-day washout period. Clinically relevant hypoglycemia (<54 mg/dL) and severe hypoglycemia (SH) risks were calculated by analyzing the data from isCGM.

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The impact of three-dimensional (3D) dose delivery accuracy of C-arm linacs on the planning target volume (PTV) margin was evaluated for non-coplanar intracranial stereotactic radiosurgery (SRS). A multi-institutional 3D starshot test using beams from seven directions was conducted at 22 clinics using Varian and Elekta linacs with X-ray CT-based polymer gel dosimeters. Variability in dose delivery accuracy was observed, with the distance between the imaging isocenter and each beam exceeding 1 mm at one institution for Varian and nine institutions for Elekta.

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Objectives: Even in a lupus low disease activity state (LLDAS), many patients with SLE continue to face residual symptoms and disease burden. We aimed to evaluate the quality of life, activity impairment and overall work productivity impairment among patients in LLDAS. Residual disease burden was also evaluated for patients in LLDAS.

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Background: FOLFIRI (5-FU + leucovorin + irinotecan) plus ramucirumab is one of the standards in second-line metastatic colorectal cancer (CRC) patients progressing after treatment with oxaliplatin/fluoropyrimidine with bevacizumab, but there is no evidence on its efficacy without prior bevacizumab. Moreover, VEGF-D has not been confirmed as a predictive biomarker for ramucirumab's efficacy, either.

Methods: The RAINCLOUD study was a multicenter, single-arm, phase II trial conducted in Japan.

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  • Previous trials suggest no overall benefit of screening for occult cancer in patients with venous thromboembolism (VTE), but high-risk patients may still benefit.
  • A study involving 3,706 patients with acute VTE found that the incidence of newly diagnosed cancer increased over time, reaching 3.7% at one year and 7.0% at three years.
  • Factors such as older age, a history of cancer, autoimmune disorders, past major bleeding, and lack of transient VTE risk factors were identified as independent predictors for new cancer diagnoses post-VTE.
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  • The study investigates long-term outcomes of chemoimmunotherapy for extensive-stage small-cell lung cancer (ES-SCLC) using a large cohort of patients over a minimum follow-up period of 3 years.
  • Most participants were trial-eligible, with significantly better overall survival rates compared to those who were not, highlighting the impact of eligibility criteria on treatment effectiveness.
  • The results underscore the practical implications of long-term outcomes in real-world settings, aiding clinical decisions for managing ES-SCLC patients.
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Preventing subsequent fractures after vertebral augmentation is a critical clinical concern. The purpose of this study was to compare the effect of romosozumab and bisphosphonate administration on the occurrence of subsequent vertebral fractures after balloon kyphoplasty (BKP) and to identify factors associated with the occurrence of subsequent vertebral fractures. The study compared 24 patients who underwent BKP and received romosozumab with 58 control patients who underwent BKP and received bisphosphonates, all within 2 months of acute osteoporotic vertebral fracture and showing unfavorable magnetic resonance imaging prognostic factors.

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  • * Out of 1507 cancer patients studied, 4.7% experienced an ischemic stroke over a median follow-up of 1020 days, with a cumulative incidence of 4.0% at 1 year.
  • * Key risk factors for stroke include specific cancers (pancreatic, ovarian, lung), dyslipidemia, metastasis, elevated D-dimer levels, and younger age, highlighting the need for vigilant monitoring in these patients.
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  • - The study evaluated factors impacting the effectiveness of second-generation colon capsule endoscopy (CCE) in diagnosing colorectal issues, focusing on patient demographics, cleansing methods, and detection rates of polyps or tumors.
  • - Among 1,006 patients across 44 Japanese hospitals, findings revealed that younger age, male sex, and proper preparation significantly improved the success of CCE, with an overall detection rate of around 89-92% for larger colorectal tumors.
  • - CCE had a low retention rate and was generally well-accepted, with 63% of patients preferring CCE for future colonoscopies, reinforcing its safety and effectiveness when bowel preparation is adequate.
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Objectives: This study aimed to examine whether creatine kinase (CK) elevation occurs with interleukin (IL)-6 inhibitors, as in Janus kinase (JAK) inhibitors, which are reported to increase CK levels in rheumatoid arthritis.

Patients And Methods: A multicenter database of JAK inhibitor and IL-6 inhibitor treatment was retrospectively searched between January 2016 to December 2022; 142 cases (117 females, 25 males, mean age: 63.8±13.

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  • Extracorporeal membrane oxygenation (ECMO) may be necessary for some patients with severe pulmonary embolism (PE), but its clinical outcomes are not well understood.
  • *In a study analyzing data from 2035 patients with acute PE, 76 required ECMO, with findings indicating high rates of cardiac arrest (88.2%) at diagnosis and a 30-day death rate of 30.3%, all related to PE.
  • *The research highlighted significant complication rates, including a 54% incidence of major bleeding, suggesting the need for improved management strategies and future clinical trials.
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  • Elevated white blood cell (WBC) counts are identified as a risk factor for adverse outcomes in patients with venous thromboembolism (VTE) who do not have active cancer.
  • In a study involving 5,197 patients, those with the highest WBC counts (Q4) were more likely to experience severe forms of VTE like pulmonary embolism and had a significantly higher risk of death and major bleeding over five years.
  • The findings suggest that monitoring WBC counts at VTE diagnosis can help in assessing patient risk and potential outcomes.
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  • * The COMMAND VTE Registry-2 study tracked 5,197 patients with venous thromboembolism in Japan, finding that 2.3% of those with acute PE developed CTEPH over an average follow-up of 747 days.
  • * Identified risk factors for developing CTEPH included being female, longer time from symptom onset to PE diagnosis, experiencing hypoxemia, having right heart load, lower D-dimer levels, and having
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  • The simplified Pulmonary Embolism Severity Index (sPESI) score helps identify low-risk patients for home treatment of pulmonary embolism, but its use with direct oral anticoagulants hasn't been thoroughly studied.
  • A study of 2,496 patients with stable pulmonary embolism found that only 25% had an sPESI score of 0, and among those, only 17% were treated at home, though their 30-day mortality was notably low (0% vs. 4.8% in higher risk groups).
  • Factors promoting home treatment included the absence of temporary risk factors, no elevated cardiac biomarkers, and the use of direct oral anticoagulants during the acute phase.
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  • The study aimed to assess the safety and efficacy of chemoimmunotherapy in patients with extensive-stage small-cell lung cancer (SCLC) who also had mild interstitial lung disease (ILD).
  • In a trial with 21 patients, a low incidence of pneumonitis was observed, with a severe pneumonitis-free rate of 95.2% and only two patients experiencing pneumonitis during treatment.
  • The findings suggest that chemoimmunotherapy could be a viable treatment option for these patients, with a median overall survival of 10.7 months.
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Objectives: This study evaluated the effectiveness of Janus kinase inhibitors (JAKi) in patients with difficult-to-treat rheumatoid arthritis (D2T RA).

Methods: This study included 220 patients with RA who were treated with JAKi. Sixty-two patients were naïve to biological disease-modifying anti-rheumatic drugs (bDMARDs)/JAKi (1st group), 57 patients were failure to one bDMARDs/JAKi (2nd group), and 101 patients were failure to ≥ 2 bDMARDs/JAKi.

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Because hepatic stellate cells (HSCs) play a major role in fibrosis, we focused on HSCs as a potential target for the treatment of liver fibrosis. In this study, we attempted to identify drug candidates to inactivate HSCs and found that several proteasome inhibitors (PIs) reduced HSC viability. Our data showed that a second-generation PI, carfilzomib (CZM), suppressed the expression of fibrotic markers in primary murine HSCs at low concentrations of 5 or 10 nM.

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Background: The optimal subsequent treatment strategy for locally advanced non-small cell lung cancer (LA-NSCLC) after chemoradiotherapy (CRT) and consolidative durvalumab therapy remains unknown. We aimed to determine the optimal subsequent treatment strategy for this clinical population.

Materials And Methods: We retrospectively enrolled 523 consecutive patients with LA-NSCLC treated with CRT and analyzed the treatment outcomes of subsequent therapy after progression following CRT and consolidative durvalumab therapy.

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Background: Because the clinical benefit of antiplatelet therapy (APT) for patients with nonsignificant coronary artery disease (CAD) remains poorly understood, we evaluated it in patients after fractional flow reserve (FFR)-guided deferral of revascularization.

Methods And Results: From the J-CONFIRM (Long-Term Outcomes of Japanese Patients with Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), we investigated 265 patients with deferred lesions who did not require APT for secondary prevention of cardiovascular disease. A 2-year landmark analysis assessed the relationship between APT at 2 years and 5-year major cardiac adverse events (MACE: composite of all-cause death, target vessel-related myocardial infarction, clinically driven target vessel revascularization).

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  • The study focuses on remnant gastric cancer (RGC) which is rare, examining clinical findings, postoperative data, and challenges in its management among 313 patients from 17 Japanese institutions.
  • Results show that a significant portion of patients had early-stage RGC, but disease recurrence rates were notable, especially within the first few years post-surgery, with peritoneal recurrence being the most common.
  • Adjuvant chemotherapy (AC) appeared to improve recurrence-free survival significantly, suggesting that AC might offer similar benefits as in primary gastric cancer despite some limitations in the study design.
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  • A study in Japan compared outcomes of patients with venous thromboembolism (VTE) treated with warfarin (2010-2014) versus direct oral anticoagulants (DOACs) (2015-2020) from two multicenter registries.
  • The use of DOACs skyrocketed from 2.6% in the warfarin era to 79% in the DOAC era, leading to a significant reduction in the 5-year recurrence rate of VTE (10.5% to 9.5%).
  • However, the incidence of major bleeding remained similar between the two eras, indicating that while DOACs may reduce VTE recurrence, concerns about bleeding risks continue.
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Background: Repeat endoscopic submucosal dissection for metachronous recurrence of esophageal squamous cell carcinoma close to previous endoscopic submucosal dissection scars is challenging. Therefore, this study evaluated the efficacy and safety of repeat endoscopic submucosal dissection for recurrent esophageal squamous cell carcinoma.

Methods: The study included 1680 patients.

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  • The PE-SARD bleeding score was developed to predict early major bleeding in patients with pulmonary embolism (PE) but has not been fully validated externally.
  • A study using data from the COMMAND VTE Registry involving 2,781 acute PE patients categorized them into high, intermediate, and low-risk groups based on this score, revealing a clear increase in bleeding rates with higher risk scores.
  • The results indicated the score has modest effectiveness in predicting bleeding risk overall, with better performance in patients without active cancer.
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