52 results match your criteria: "Shimada General Medical Center.[Affiliation]"

Introduction: Sebaceous carcinoma (SC) is a malignant neoplasm differentiated from the mature sebocyte and occurs mainly in the periorbital area. However, SC of the breast is extremely rare. We report a case of sebaceous breast carcinoma in a Japanese man with a pathogenic variant.

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Purpose: The dual-layer multileaf collimator (MLC) in Halcyon adds complexities to the dose calculation process owing to the variability of dosimetric characteristics with leaf motion. Recently, an enhanced leaf model (ELM) was developed to refine the MLC model in the Eclipse treatment planning system. This study investigates the performance of the Halcyon ELM by verifying doses for simple slit fields and volumetric modulated arc therapy (VMAT) plans.

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Mohs' hydrophilic cream is a formulation with improved convenience by changing the base material of the conventional Mohs' paste to a hydrophilic cream. We report a case in which Mohs' hydrophilic cream was effective in treating bleeding from breast cancer with cancerous skin ulcers. The patient was a 68-year-old woman.

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Background: Fatal arrhythmic events (FAEs), such as sudden cardiac death (SCD) and fatal ventricular arrhythmias, are a devastating complication in patients with coronary artery disease (CAD). Therefore, in this study we aimed to assess the incidence of FAEs in more recent Japanese patients with CAD and to examine whether risk stratification of FAEs can still be feasible using the left ventricular ejection fraction (LVEF).

Methods And Results: In the CREDO Kyoto PCI/CABG registry cohorts-2 and -3, there were 25,843 patients with LVEF data who received a first coronary revascularization (LVEF ≤35% group: N=1,671, 35%45%: N=21,503).

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This study evaluated the impact of aspirin on the biochemical recurrence (BCR) rate following robot-assisted radical prostatectomy (RARP) in patients. A database search identified patients who underwent RARP for pT2-3N0M0 disease at any of 25 centers between 2011 and 2022, categorized into aspirin (n = 350) and control groups (n = 5857). Adjustment by 1:1 propensity score matching (PSM) and Mahalanobis distance matching (MDM) created 350 matched pairs.

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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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Purpose: To evaluate functional and oncological outcomes in patients who underwent unilateral or bilateral nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) for high-risk prostate cancer.

Methods: The cohort comprised 2683 patients with clinical stage T1-4, N0M0 high-risk prostate cancer who underwent RARP in Japanese tertiary care centers from August 2011 to April 2023. High risk was defined using the European Association of Urology risk stratification criteria.

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Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.

Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.

Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.

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Background: There is a paucity of data on safety of calcium channel blockers (CCB) in patients with severe aortic stenosis (AS) and hypertension.

Methods And Results: Among 2,460 patients with severe AS and hypertension receiving antihypertensive therapy in the CURRENT AS registry-2, we compared the clinical outcomes between patients taking antihypertensive therapy with CCB (CCB group) and without CCB (no CCB group). In the entire study population, CCB was prescribed in 1,763 patients (71.

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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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  • * TAVI centers preferred aortic valve replacement (AVR) treatments, with a higher percentage opting for transcatheter aortic valve implantation (TAVI) compared to non-TAVI centers (71% vs. 23%).
  • * Despite the differences in treatment frequency, both types of centers showed similar rates of all-cause death or heart failure hospitalizations over three years, indicating no significant outcome difference.
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  • The study compares the efficiency of RFID-tagged versus barcode-engraved surgical instruments in terms of reading times and operator proficiency to improve patient safety and reduce healthcare burdens.!* -
  • Results show RFID reading times were significantly shorter (64s for skilled, 79s for unskilled) compared to barcodes (190s for skilled, 212s for unskilled), revealing RFID's superior efficiency.!* -
  • RFID technology not only reduces labor costs (estimated $24,146-$42,322 per year) but also enhances patient safety by minimizing reliance on the operator's skill set.!*
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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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  • 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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  • - A new prognostic model was developed to predict cancer-specific survival (CSS) for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC) using data from 1,092 Japanese patients treated between 2014 and 2020.
  • - Key factors for predicting CSS included disease severity, liver metastasis, certain lab results, and primary tumor characteristics, leading to significant differences in 5-year CSS rates among low-risk (86%) and high-risk (22%) groups.
  • - This model displayed high accuracy and reproducibility, and it may help tailor treatment approaches for patients with mHSPC, especially in determining the intensity of therapies needed.
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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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Purpose: We evaluated the efficacy and safety of antiemetic therapy with olanzapine, a neurokinin-1 receptor antagonist (RA), a 5-hydroxytryptamine-3 (5-HT) RA, and dexamethasone for preventing chemotherapy-induced nausea and vomiting in patients receiving carboplatin-containing chemotherapy.

Patients And Methods: Chemotherapy-naïve patients scheduled to receive carboplatin (AUC ≥5) were randomly assigned to receive either olanzapine 5 mg once daily (olanzapine group) or placebo (placebo group) in combination with aprepitant, a 5-HT RA, and dexamethasone. The primary end point was the complete response (CR; no vomiting and no rescue therapy) rate in the overall phase (0-120 hours).

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Isolated cortical vein thrombosis (ICVT) is a rarer subtype of cerebral venous sinus thrombosis (CVST) that involves only the cortical veins without any thrombosis in the major cerebral veins or sinuses. Among the known causes of CVST are factors, such as being a young female or the use of hormonal preparations. This study presents a case of a 35-year-old female who underwent endometrial polyp removal 5 days before symptom onset and started using a transdermal estradiol patch.

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  • Statins are suggested to help prevent recurrent venous thromboembolism (VTE), based on findings from a large study of over 5,000 VTE patients in Japan.
  • The study divided patients into two groups based on statin use at discharge, revealing that the group using statins had a significantly lower incidence of recurrent VTE compared to the non-statin group (6.8% vs. 10.1%) over five years.
  • Although statins also showed a trend towards reducing major bleeding risk, this was not statistically significant after adjusting for confounding factors.
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Lysyl oxidase-like 2 (LOXL2) mediates the crosslinking of extracellular collagen, reflecting qualitative changes in liver fibrosis. This study aimed to validate the utility of serum LOXL2 levels as a predictive biomarker for the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) infection who achieved a sustained virological response (SVR). This retrospective study included 137 patients with chronic HCV infection without history of HCC development and who achieved SVR via direct-acting antiviral therapy.

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