202 results match your criteria: "St. Marianna University School of Medicine Hospital[Affiliation]"

Utility values of responders and nonresponders are essential inputs in cost-effectiveness studies of radiation therapy for painful bone metastases but, to our knowledge, they have not been reported separately. We sought to determine the utility values of responders and nonresponders using data from a prospective observational study on bone metastases. The original prospective observational study was conducted at 26 centers in Japan.

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Background: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) for mitral regurgitation, but the relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate the association of baseline MVA with procedural and clinical outcomes in patients undergoing TEER with MitraClip from the OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral).

Methods: A total of 1768 patients undergoing TEER were divided into 3 groups according to baseline MVA: group 1: <4.

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Article Synopsis
  • This study explores the relationship between handgrip strength and all-cause mortality in patients undergoing transcatheter edge-to-edge repair (TEER) for heart issues, suggesting that weaker grip strength could indicate a higher risk of death post-procedure.
  • It includes data from the OCEAN-Mitral Registry, which analyzed handgrip tests of 2077 patients before TEER, with follow-ups showing varied changes in strength based on the success of the procedure.
  • The findings suggest that improving mitral regurgitation (MR) post-TEER can positively impact frailty and resilience, making this research a significant insight into patient outcomes in heart-related treatments.
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  • This study examined how left ventricular ejection fraction (LVEF) changes after a specific heart valve repair procedure called transcatheter edge-to-edge valve repair (TEER) in patients with mitral regurgitation (MR).
  • Findings revealed that 32% of patients experienced worsened LVEF after the procedure, linked to increased end-systolic volumes in the heart and certain predictors like higher LVEF and levels of B-type natriuretic peptide.
  • Despite the LVEF worsening, long-term outcomes (like death or hospitalization for heart failure) were similar for both patients with worsened and preserved LVEF, indicating that LVEF change might not significantly impact overall health results post-TEER
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Impact of nutritional status in patients with metastatic spinal tumors who underwent palliative surgery.

J Orthop Sci

November 2024

Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa Prefecture, 216-8511, Japan.

Background: Preoperative nutritional status significantly affects postoperative outcomes in patients with metastatic spinal tumors. Understanding the relationship between nutritional status and survival rates can help optimize treatment strategies and improve patient outcomes.

Methods: This retrospective study was performed on 57 patients who underwent palliative surgery between May 2009 and April 2023.

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The role of external-beam radiotherapy for differentiated thyroid cancer.

Jpn J Clin Oncol

November 2024

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

The treatment options for differentiated thyroid cancer (DTC) are surgery, thyroid stimulating hormone suppression, radioactive iodine, and multitargeted tyrosine kinase inhibitors. The role of external-beam radiotherapy (EBRT) for DTC is controversial because of the lack of randomized controlled trials, but prospective single-arm studies and propensity score matching analyses have shown its efficacy and safety. This review discusses the role of EBRT after resection of gross disease, when there is a high risk of locoregional failure, as well as its role for locoregionally gross recurrent and unresectable disease.

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Background: The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge-to-edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post-MR ≥2+) after transcatheter edge-to-edge repair.

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  • * Out of 1474 patients analyzed, 18.4% received higher doses of beta-blockers one month post-surgery, showing a significant association with lower risks of all-cause and cardiovascular mortality.
  • * The findings suggest that adjusting beta-blocker therapy after M-TEER can lead to improved outcomes, particularly for patients with a low left ventricular ejection fraction (LVEF) of 40% or less.
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Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study.

Clin Microbiol Infect

December 2024

OUTCOMEREA Research Group, Drancy, France; Institut National de la Santé et de la Recherche Medicale, Infection Antimicrobial Modelisation Evolution, U1137, Team Decision Science in Infectious Diseases, Paris, France; Assistance Publique Hôpitaux de Paris, Bichat hospital, Medical and infectious diseases ICU, F75018, Paris France. Electronic address:

Article Synopsis
  • Hospital-acquired bloodstream infections (HA-BSI) in ICU patients can be life-threatening, and this study aimed to see how early adequate antibiotic treatment affects 28-day mortality rates for patients who survive at least one day after infection onset.
  • Using data from a multicenter study with 2,418 patients, researchers found that those who received adequate treatment within 24 hours had a lower 28-day mortality rate (32.8%) compared to those who were inadequately treated (40%).
  • The study concluded that inadequate antibiotic therapy within 24 hours contributes significantly to 28-day mortality, indicating that quicker treatment could greatly improve patient outcomes in cases of HA-BSI.
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Article Synopsis
  • - The study investigates how mismatched residual mitral regurgitation (MR) and left atrial pressure (LAP) after a specific heart procedure (TEER) can negatively impact clinical outcomes in patients with severe MR and heart failure.
  • - Researchers categorized 1,477 patients into three groups based on their MR and LAP levels, finding that those with mismatched or poor conditions faced higher risks of death and heart failure hospitalization compared to those in an optimal state.
  • - Six key factors were identified as predictors of hemodynamic mismatch after TEER, including body mass index and pre-procedural pressures, suggesting that monitoring these could help improve patient outcomes.
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Aims: Mitral transcatheter edge-to-edge repair (M-TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M-TEER candidates for effective patient selection, optimal periprocedural care and improved long-term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported.

Methods And Results: Between April 2018 and June 2021, 2149 patients undergoing M-TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.

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Complex chromosomal 6q rearrangements revealed by combined long-molecule genomics technologies.

Genomics

September 2024

Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan; Department of Rare Disease Genomics, Yokohama City University Hospital, Yokohama 236-0004, Japan; Department of Clinical Genetics, Yokohama City University Hospital, Yokohama 236-0004, Japan. Electronic address:

Technologies for detecting structural variation (SV) have advanced with the advent of long-read sequencing, which enables the validation of SV at a nucleotide level. Optical genome mapping (OGM), a technology based on physical mapping, can also provide comprehensive SVs analysis. We applied long-read whole genome sequencing (LRWGS) to accurately reconstruct breakpoint (BP) segments in a patient with complex chromosome 6q rearrangements that remained elusive by conventional karyotyping.

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Focal muscle vibration (FMV) is increasingly being recognized as a rehabilitative therapy for enhancing motor function in central nervous system (CNS) diseases, particularly in patients with fine motor control deficits stemming from CNS damage. Brain lesions from these diseases disrupt the motor networks, necessitating novel rehabilitation strategies. By applying vibrations to muscles, FMV stimulates sensory fibers to induce cortical activity and kinesthetic illusions.

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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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Background: The extent of cardiac damage and its association with clinical outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for degenerative mitral regurgitation remains unclear. This study was aimed to investigate cardiac damage in patients with degenerative mitral regurgitation treated with TEER and its association with outcomes.

Methods: We analyzed patients with degenerative mitral regurgitation treated with TEER in the Optimized Catheter Valvular Intervention-Mitral registry, which is a prospective, multicenter observational data collection in Japan.

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Background: The phase 3 BEACON CRC study demonstrated the survival benefits of encorafenib and cetuximab, with or without binimetinib (the BEACON triplet or doublet regimen), for BRAF-mutant metastatic colorectal cancer (mCRC). This expanded access program (EAP) and subsequent follow-up study assessed the efficacy and safety of the BEACON triplet regimen in Japanese patients with BRAF-mutant mCRC.

Materials And Methods: The EAP was an open-label, single-arm study including Japanese patients with BRAF-mutant mCRC whose disease progressed after 1 to 2 prior regimens.

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Purpose: During computed tomography pulmonary angiography (CTPA), a decrease in the CT value of the pulmonary artery may be observed due to poor contrast enhancement, even though the imaging is performed at the optimum timing while continuously injecting a contrast medium. This study focused on the increase in blood flow in the superior and inferior vena cava during inspiration that affects the decrease in the CT value of the pulmonary artery and investigated a radiography method in which a delay time was set after inspiration in clinical cases.

Methods: A total of 50 patients who underwent CTPA for suspected pulmonary thromboembolism were included.

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Article Synopsis
  • Transcatheter edge-to-edge mitral valve repair (TEER) is gaining attention as a treatment for significant secondary mitral regurgitation, especially in patients with chronic heart failure.* -
  • The study analyzed 1,517 patients from the OCEAN-Mitral registry to identify factors linked to cardiac death within a year following TEER, finding that previous heart failure admissions, use of intravenous inotropes, and high plasma B-type natriuretic peptide levels were significant predictors.* -
  • Researchers created a new risk-scoring system based on these factors, successfully distinguishing different levels of 1-year cardiac mortality risk (16%, 8%, and 4%), which can help clinicians tailor treatment strategies.*
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Article Synopsis
  • Transcatheter edge-to-edge repair (TEER) with MitraClip is a minimally invasive treatment for mitral regurgitation (MR), but comprehensive data on its safety and effectiveness is limited, especially for the fourth-generation (G4) system.
  • The OCEAN-Mitral Registry, involving 21 centers in Japan, enrolled 2,150 patients with MR to analyze their characteristics, procedural details, and clinical outcomes between April 2018 and June 2021.
  • Findings indicated that 94.6% of patients achieved acute procedural success with both the G2 and G4 systems, although the G4 system showed promise for improved outcomes with a multidisciplinary approach.
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Background: Glucocorticoids are associated with an increased risk of venous thrombosis. Glucocorticoid treatment increases coagulation factor and anticoagulant levels; however, its effect on hemostatic function remains unclear. This study aimed to investigate the changes in comprehensive coagulation profiles after glucocorticoid treatment in noninflammatory diseases to elucidate the direct contribution of glucocorticoids to hemostatic function.

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Epilepsy with eyelid myoclonia is a childhood-onset generalized epilepsy, which is more common in women. Over 90% of the patients continue antiseizure medications, especially valproate, and more than 60% of cases are refractory. The efficacy of vagus nerve stimulation in treating eyelid myoclonia is still unknown.

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Clinical outcomes of Indigenous Australians and New Zealand Māori with metabolic acidosis and acidaemia.

Crit Care Resusc

March 2022

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

To assess the incidence and impact of metabolic acidosis in Indigenous and non-Indigenous patients Retrospective study. Adult intensive care units (ICUs) from Australia and New Zealand. Patients aged 16 years or older admitted to an Australian or New Zealand ICU in one of 195 contributing ICUs between January 2019 and December 2020 who had metabolic acidosis, defined as pH < 7.

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Article Synopsis
  • - This study investigated the relationship between the severity of contrast extravasation (CE) seen on CT scans and the need for massive transfusions (MT) in children with blunt liver and/or spleen injuries, over a span from 2008 to 2019.
  • - The research included 1,407 pediatric patients, revealing that 14% required MT, and specific types of CE, particularly intraparenchymal and into the peritoneal cavity, significantly correlated with increased transfusion needs.
  • - The findings suggest that recognizing active CE during initial CT scans can guide healthcare providers in making informed decisions about transfusion strategies for young patients with these types of injuries.
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Background Limited data are available about clinical outcomes and residual mitral regurgitation (MR) after transcatheter edge-to-edge repair in the large Asian-Pacific cohort. Methods and Results From the Optimized Catheter Valvular Intervention (OCEAN-Mitral) registry, a total of 2150 patients (primary cause of 34.6%) undergoing transcatheter edge-to-edge repair were analyzed and classified into 3 groups according to the residual MR severity at discharge: MR 0+/1+, 2+, and 3+/4+.

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Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan.

Endocr J

October 2023

Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan.

The role of adjuvant external-beam radiotherapy (EBRT) for locally advanced differentiated thyroid cancer (DTC) is controversial because of the lack of prospective data. To prepare for a clinical trial, this study investigated the current clinical practice of adjuvant treatments for locally advanced DTC. A survey on treatment selection criteria for hypothetical locally advanced DTC was administered to representative thyroid surgeons of facilities participating in the Japan Clinical Oncology Group Radiation Therapy Study Group.

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