Urinary protein-to-creatinine ratio in pregnant women after dipstick testing: prospective observational study.

Background: The dipstick test is widely used as a primary screening test for detection of significant proteinuria in pregnancy (SPIP). However, it often shows a false positive test result. This study was performed to determine which pregnant women should be recommended to undergo determination of urinary protein-to-creatinine ratio (mg/mg, P/Cr test) after dipstick test for confirmation of SPIP.

Randomized trial of ultrasound-indicated cerclage in singleton women without lower genital tract inflammation.

Aim: This is the first report of a randomized trial of cerclage on pure cervical shortening without vaginosis or cervicitis. The objective of our multicenter randomized controlled trial was to assess the benefits of ultrasound-indicated cervical cerclage in the mid-trimester to prevent preterm birth in women who have no signs of infection or inflammation of the lower genital tract.

Material And Methods: Women with a short cervical length < 25 mm between 16 and 26 weeks of gestation were randomly assigned to receive a Shirodkar cerclage, McDonald cerclage, or bedrest (no cerclage).

Osteoprotegerin is Associated With Endothelial Function and Predicts Early Carotid Atherosclerosis in Patients With Coronary Artery Disease.

Osteoprotegerin (OPG) is a soluble glycoprotein belonging to the tumor necrosis factor receptor superfamily and is linked to vascular atherosclerosis and calcification. The carotid intima-media thickness (CIMT) correlates with carotid atherosclerosis and is a significant predictor of cardiovascular events. The OPG levels are associated with the CIMT in coronary artery disease (CAD) patients.

Atypical Fast-Slow Atrioventricular Nodal Reentrant Tachycardia Incorporating a "Superior" Slow Pathway: A Distinct Supraventricular Tachyarrhythmia.

Background: The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed.

Methods And Results: We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients.

Low-dose corticosteroid treatment and mortality in refractory abdominal septic shock after emergency laparotomy.

Background: The role of low-dose corticosteroid as an adjunctive treatment for abdominal septic shock remains controversial.

Methods: We identified refractory septic shock patients who required noradrenaline and at least one of other vasopressor/inotropic (dopamine, dobutamine or vasopressin) following emergency open laparotomy for perforation of the lower intestinal tract between July 2010 and March 2013 using the Japanese Diagnosis Procedure Combination inpatient database. In-hospital mortality was compared between the low-dose corticosteroid and control groups.

Changes in Therapeutic Hypothermia and Coronary Intervention Provision and In-Hospital Mortality of Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Database Study.

Objectives: To evaluate the change in provision of therapeutic hypothermia and coronary intervention (postresuscitation care) over time and to clarify the association between these provisions and in-hospital mortality in patients with out-of-hospital cardiac arrest.

Design: A nationwide retrospective cohort study using multiple propensity score analyses.

Setting: Japanese Diagnosis Procedure Combination inpatient database.

Prophylactic Antibiotics May Improve Outcome in Patients With Severe Burns Requiring Mechanical Ventilation: Propensity Score Analysis of a Japanese Nationwide Database.

Background: The use of prophylactic antibiotics for severe burns in general settings remains controversial and is not suggested by recent guidelines owing to lack of evidence for efficacy. We examined the hypothesis that prophylactic systemic antibiotic therapy may reduce mortality in patients with severe burns.

Methods: We identified 2893 severe burns patients (burn index ≥ 10) treated at 583 hospitals between July 2010 and March 2013 using the Japanese diagnosis procedure combination inpatient database.

Use of warfarin in elderly patients with non-valvular atrial fibrillation -- subanalysis of the J-RHYTHM Registry.

Background: To clarify the effects of warfarin therapy in very old patients with non-valvular atrial fibrillation (NVAF), a post-hoc analysis was performed using the data of the J-RHYTHM Registry.

Methods and results: A consecutive series of AF outpatients was enrolled from 158 institutions. Of 7,937 patients, 7,406 with NVAF (men, 70.

Normative Data and Predictive Equation of Interrupter Airway Resistance in Preschool Children in Japan.

Measurement of interrupter airway resistance (Rint) is a convenient alternative to standard spirometry for assessing respiratory function in uncooperative young children. The aim of the present prospective study was to establish the normative data and predictive equation of Rint in Japanese preschool children. A total of 214 children were enrolled from a single kindergarten; however, 129 were excluded because they met at least 1 of the exclusion criteria, such as wheezing history or recent common cold.

Utility of immunohistochemistry with an antibody against MYC at the initial diagnosis of follicular lymphoma, grade 3A, for predicting a more aggressive clinical course: a case report and review of the literature.

Follicular lymphoma (FL) is the most common indolent lymphoma, and associated with the chromosomal translocation t(14;18)(q32;q21). While, FL harboring both BCL2 and MYC translocation at diagnosis is very rare. The evaluation of MYC expression in typical FL at presentation using southern blot, G-banded karyotyping or fluorescence in situ hybridization (FISH) analyses has been described so far.

Non-valvular atrial fibrillation patients with low CHADS2 scores benefit from warfarin therapy according to propensity score matching subanalysis using the J-RHYTHM Registry.

Introduction: Recently, direct-acting oral anticoagulants (DOACs) have been introduced, with increasing use in patients with non-valvular atrial fibrillation (NVAF). However, warfarin continues to be widely used and the benefits and risks of warfarin in NVAF patients warrant closer inspection.

Materials And Methods: Thromboembolism, major hemorrhage, and total and cardiovascular mortalities were analyzed in 7,406 NVAF patients in the J-RHYTHM Registry from January to July 2009, prior to DOAC introduction.

Differential Effects of Atorvastatin and Pitavastatin on Inflammation, Insulin Resistance, and the Carotid Intima-Media Thickness in Patients with Dyslipidemia.

Aims: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have multiple pleiotropic effects, such as anti-inflammatory and vascular endothelium protection, that are independent of their low-density-lipoprotein (LDL) cholesterol lowering effects. However, whether different statins exert diverse effects on inflammation, insulin resistance, and the progression of carotid atherosclerosis [as indicated by the intima-media thickness (CIMT)] in patients with dyslipidemia remains unclear.

Methods: A total of 146 patients with hypercholesterolemia without known cardiovascular disease were randomly assigned to receive 5 mg/day of atorvastatin (n=73) or 1 mg/day of pitavastatin (n=73).

Fish consumption and resilience to depression in Japanese company workers: a cross-sectional study.

Background: Depression is a common disorder that is influenced by psychosocial factors in the workplace. Increasing resilience, the ability to cope with stress in the face of adversity, is considered an important strategy to prevent depression. It has been suggested that consumption of fish, which is a major source of long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), may prevent depression.

Spontaneous rupture of a simple hepatic cyst: report of a case.

We describe the spontaneous rupture of a simple hepatic cyst. A 62-year-old woman was admitted for right upper quadrant pain of sudden onset. The patient denied a history of abdominal trauma.

A case of primary pulmonary diffuse large B-cell lymphoma diagnosed by transbronchial biopsy.

A 76-year-old man took a chest X-ray for his medical checkup and an abnormal shadow was detected in the right lower lung field. For more detailed examination, he was referred to our hospital. Chest computed tomography showed a 20-mm nodule with relatively regular margins in the right lower lobe.

Fetal/Placental weight ratio in term Japanese pregnancy: its difference among gender, parity, and infant growth.

Purpose: The "inappropriately heavy placenta" has been considered to be associated with various pregnancy disorders; however, data is scarce what factors affect it. To determine whether the following three affect it; (1) infant gender and mother's parity, (2) growth restriction, and (3) preeclampsia.

Methods: We employed fetal/placental weight ratio (F/P).

Technical arrangement of the Williams-Isu method for anterior cervical discectomy and fusion.

Anterior cervical fixation with autologous bone transplantation-without the need for harvesting bone from other sites, such as the ilium-was developed by Williams and modified by Isu et al. In recent intervertebral fusion procedures, after harvesting the cuboid bone from vertebral bodies, a hydroxyapatite block is placed between two harvested vertebral bones in the same way as in the sandwich method for intervertebral fixation. According to previous studies, this procedure has the following disadvantages: (i) as the corrective force for cervical kyphosis is insufficient, it could not be adapted for patients with preoperative kyphosis; (ii) special devices, including a microsurgical saw, are required for harvesting vertebral bones.

Effect of a selective neutrophil elastase inhibitor on mortality and ventilator-free days in patients with increased extravascular lung water: a post hoc analysis of the PiCCO Pulmonary Edema Study.

Background: Neutrophil elastase plays an important role in the development and progression of acute respiratory distress syndrome (ARDS). Although the selective elastase inhibitor, sivelestat, is widely used in Japan for treating ARDS patients, its effectiveness remains controversial. The aim of the current study was to investigate the effects of sivelestat in ARDS patients with evidence of increased extravascular lung water by re-analyzing a large multicenter study database.

Spontaneous ruptured hepatocellular carcinoma.

The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Spontaneous rupture of HCC occasionally occurs, and ruptured HCC with intraperitoneal hemorrhage is potentially life-threatening. The most common symptom of ruptured HCC is acute abdominal pain.