Comparing the efficacy of tadalafil and tamsulosin for managing erectile dysfunction and lower urinary tract symptoms in prostate brachytherapy patients: a prospective study.

Introduction: Adverse events, such as erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are significant concerns in prostate cancer (PCa) patients treated with Iodine 125 (I-125) low-dose rate (LDR) prostate brachytherapy (PB). Alpha antagonists and phosphodiesterase-5 inhibitors are used to manage these events. The present study compared the efficacy of low-dose tadalafil with that of tamsulosin for concomitant ED and LUTS in PCa patients treated with I-125 LDR PB.

Hepatocellular carcinoma converted from atezolizumab and bevacizumab combination therapy: a case report.

Hepatectomy is the curative treatment for hepatocellular carcinoma (HCC), with targeted therapy used when resection is difficult. In this rare case, the tumor shrank with targeted therapy, enabling radical treatment through conversion surgery. The patient, a man in his 70s, developed an 11.

PLK1 overexpression suppresses homologous recombination and confers cellular sensitivity to PARP inhibition.

The overexpression of Polo-like kinase 1 (PLK1) is associated with poor clinical outcomes in various malignancies, making it an attractive target for anticancer therapies. Although recent studies suggest PLK1's involvement in homologous recombination (HR), the impact of its overexpression on HR remains unclear. In this study, we investigated the effect of PLK1 overexpression on HR using bioinformatics and experimental approaches.

Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.

Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

Results: A total of 6575 patients with CDB were included.

Health Utility of Pain Response Versus Nonresponse to Palliative Radiation Therapy for Symptomatic Bone Metastases: Analyses Based on Real-World Data from 26 Centers.

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.

The impact of uterine cavity structural features on reproductive outcomes in T-shaped uterine malformation.

Objectives: Despite advancements in modern medicine, the effectiveness of in vitro fertilization (IVF) remains low. This study aimed to assess the impact of specific features of T-shaped uterine cavity malformation and its intermediate forms on reproductive function and the effectiveness of assisted reproductive technology (ART), particularly on IVF results and pregnancy outcomes.

Methods: A prospective cohort study included 388 somatically healthy patients undergoing 3D ultrasound (US) examination of the uterine cavity before embryonic transfer for IVF treatment.

Efficacy of Donepezil for Fatigue and Psychological Symptoms in Post-COVID-19 Condition: Study Protocol for a Multicenter Randomized, Placebo-controlled, Double-blind Trial.

Background: Approximately 30% of coronavirus disease 2019 COVID-19 patients develop fatigue and psychological symptoms. We previously demonstrated the efficacy of donepezil, an acetylcholinesterase inhibitor that is widely used to treat dementia, in basic research.

Methods: This is a multicenter, double-blind, randomized, controlled, phase II clinical trial in which 120 patients with COVID-19 will be randomized in a 1:1 ratio to a donepezil or placebo group.

Infectious Thoracoabdominal Aortic Aneurysm Repair in a Patient with Myasthenia Gravis: A Case Report.

Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder that rarely coexists with infectious thoracoabdominal aortic aneurysms (TAAA) requiring open repair. A 57-year-old patient with MG underwent elective thoracoabdominal aortic replacement. He was diagnosed with MG (Osserman classification II A).

Atherogenic Dyslipidemia Is Critically Related to Aortic Complicated Lesions in Cryptogenic Stroke.

Aims: Atherogenic dyslipidemia (AD) is regarded as a residual risk of cardiovascular diseases characterized by low high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) levels and related to the intracranial stenosis of atheromatous thrombotic brain infarction (ATBI). Further, atherosclerosis is possibly related to another stroke subtype, including cryptogenic stroke (CS). In particular, an aortic complicated lesion (ACL) is a notable embolic source of CS, since recurrence of aortogenic brain embolism is not rare.

Development of Machine-learning Model to Predict Anticoagulant Use and Type in Geriatric Traumatic Brain Injury Using Coagulation Parameters.

This study aimed to investigate the patterns of anticoagulation therapy and coagulation parameters and to develop a prediction model to predict the type of anticoagulation therapy in geriatric patients with traumatic brain injury. A retrospective analysis was performed using the nationwide neurotrauma database of Japan. Elderly patients (≥65 years) with traumatic brain injury.

Adagrasib in KRYSTAL-12 has Not Broken the KRAS G12C Enigma Code of the Unspoken 6-Month PFS Barrier in NSCLC.

Mutations in KRAS G12C are among the more common oncogenic driver mutations in non-small cell lung cancer (NSCLC). In December 2022, the US Food and Drug Administration (FDA) granted accelerated approval to adagrasib, a small molecule covalent inhibitor of KRAS G12C, for the treatment of patients with locally advanced or metastatic KRAS G12C mutant NSCLC who received at least one prior systemic therapy based on promising results from phase 1 and 2 trials wherein adagrasib demonstrated a median PFS of 6.5 months.

Patient-Centric Approach to Personalized Electronic Medical Records via QR Code in Japan.

Government policies in the United States and the European Union promote standardization and value creation in the use of FAIR (findability, accessibility, interoperability, and reusability) data, which can enhance trust in digital health systems and is crucial for their success. Trust is built through elements such as FAIR data access, interoperability, and improved communication, which are essential for fostering innovation in digital health technologies. This Viewpoint aims to report on exploratory research demonstrating the feasibility of testing a patient-centric data flow model facilitating semantic interoperability on precision medical information.

Efficacy and Safety of Sodium Zirconium Cyclosilicate in the Management of Hyperkalemia in Patients with Heart Failure with Reduced and Mildly Reduced Ejection Fraction and Chronic Kidney Disease Treated with Spironolactone: Rationale for and Design of the REGISTA-K Trial.

Background: To evaluate whether sodium zirconium cyclosilicate (SZC) enables the up-titration of spironolactone without increasing the risk of hyper- and hypokalemia in patients with heart failure with reduced and mildly reduced ejection fraction (HFrEF and HFmrEF) and moderate/severe chronic kidney disease (CKD) who developed hyperkalemia during treatment with suboptimal spironolactone dose.

Methods: The REGISTA-K is a randomized, double-blind, placebo-controlled, multicenter trial that examined the efficacy and safety of SZC in up-titrating spironolactone without the occurrence of hyperkalemia or hypokalemia. A total of 266 patients with HFrEF and HFmrEF and hyperkalemia will be randomized in a 1:1 ratio to receive either SZC or placebo after treating hyperkalemia with SZC at 25 sites in Japan.

Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study.

Background: Lower gastrointestinal perforation (LGP) is an acute abdominal condition associated with a high mortality rate. Timely and accurate diagnosis is crucial. Nevertheless, a diagnostic delay has been estimated to occur in approximately one-third of the cases, and the factors contributing to this delay are yet to be clearly understood.

Prevalence, management, health-care burden, and 90-day outcomes of prolonged mechanical ventilation in the paediatric intensive care unit (LongVentKids): an international, prospective, cross-sectional cohort study.

Background: The number of children requiring prolonged mechanical ventilation (PMV) has increased with the advancement of medical care. We aimed to estimate the prevalence of PMV worldwide, document demographic and clinical characteristics of children requiring PMV in paediatric intensive care units (PICUs), and to understand variation in clinical practice and health-care burden.

Methods: This international, multicentre, cross-sectional cohort study screened participating PICUs in 28 countries for children aged >37 postgestational weeks to 17 years who had been receiving mechanical ventilation (MV; invasive or non-invasive) for at least 14 consecutive days.

Analysis of COVID-19 nosocomial clusters in an Omicron strain epidemic: importance of patient education on infection control measures.

A cluster of 129 patients with coronavirus disease 2019 (COVID-19) nosocomial infections was analysed during the Omicron strain epidemic. The incubation period for nosocomial Omicron strain infections was found to be 3 days. The transmission route of the first patient with COVID-19 (FCP) in each room is a critical factor within these clusters.

Association of Baseline Mitral Valve Area With Procedural and Clinical Outcomes of Mitral Transcatheter Edge-to-Edge Repair: Insights From the OCEAN-Mitral Registry.

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.

A Case of Cavernous Sinus Fistula Caused by Ruptured Spontaneous Aneurysm on Persistent Primitive Trigeminal Artery.

The most frequent of the embryonic persistent arteries that connect the internal carotid artery to the posterior circulation is the persistent primitive trigeminal artery (PPTA), which is recognized on 0.1%-0.6% on the basis of conventional angiography or magnetic resonance imaging (MRI).

Surgical outcomes and learning curve of complex versus simple segmentectomy for uniportal video-assisted thoracoscopic surgery: an initial experience of 100 cases of a single experienced surgeon.

Background: Complex segmentectomy for uniportal video-assisted thoracoscopic surgery (VATS) remains controversial due to procedural complexity and the risk of increased complications, unlike multiportal VATS. Demonstrating the perioperative results and proficiency of individual surgeon is believed to influence future dissemination for uniportal VATS. In this study, we aimed to compare the perioperative outcomes and learning curves of complex versus simple segmentectomy for uniportal VATS.

Coil Embolization and Endoscopic Hematoma Removal for Ruptured Cerebral Aneurysm With Intracranial Hematoma Under Local Sedation: A Case Report.

Intracerebral hematomas (ICHs) can complicate ruptured cerebral aneurysms. The standard approach for these cases has traditionally involved craniotomy with clipping and hematoma evacuation. Recently, however, a combination of coil embolization and neuroendoscopic hematoma removal has shown promise.

Management strategy and experience of vasa previa in perinatal centers: A nationwide survey in Japan.

Aim: To clarify the current situation and outcomes of vasa previa (VP) in Japan.

Methods: A questionnaire survey on VP was conducted at all 408 perinatal centers in Japan. The content of the survey included (1) the management strategy for pregnant women who were diagnosed with VP and (2) the number and outcomes of VP cases managed between January 2020 and December 2022.