Does the loot box open the door to addiction? A case report of gaming disorder with high charges for loot box purchases.

Background: A loot box is a gaming term for an electronic lottery that randomly provides items that enhance the gaming experience. In recent years, loot boxes have been increasingly discussed as a risk factor of gaming disorder (GD). While they may be purchased for a few dollars at a time, the cumulative expenses resulting from their addictive use have become a social problem.

Impact of Atrial Fibrillation Triggers on Long-Term Outcomes of a Second Catheter Ablation of Nonparoxysmal Atrial Fibrillation.

Catheter ablation (CA) of atrial fibrillation (AF) triggers, including non-pulmonary vein (PV) foci, contributes to improved procedural outcomes. However, the clinical significance of an AF trigger ablation during second CA procedures for nonparoxysmal AF is unknown. We enrolled 94 patients with nonparoxysmal AF undergoing a second CA.

Rationale and Design of the Effect of Ivabradine on Exercise Tolerance in Patients With Chronic Heart Failure (EXCILE-HF) Trial - Protocol for a Multicenter Randomized Controlled Trial.

A high resting heart rate is an independent risk factor for mortality and morbidity in patients with cardiovascular diseases. Ivabradine selectively inhibits the funny current ( ) and decreases heart rate without affecting cardiac conduction, contractility, or blood pressure. The effect of ivabradine on exercise tolerance in patients with heart failure with reduced ejection fraction (HFrEF) on standard drug therapies remains unclear.

Impact of three major risk factors on clinical outcomes in patients with nonvalvular atrial fibrillation receiving rivaroxaban: Sub-analysis from the XAPASS study.

Background: To evaluate the impact of three risk factors (age [≥75 years], renal impairment [creatinine clearance <50 ml/min], and low body weight [≤50 kg]) on the risk of any bleeding events, all-cause mortality, and stroke, non-central nervous system (non-CNS) systemic embolism (SE), and myocardial infarction (MI) in patients with nonvalvular atrial fibrillation (NVAF) treated with rivaroxaban in a real-world clinical setting.

Methods: The Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) is a prospective, single-arm, observational study. Enrolled patients were divided into four subgroups by the number of risk factors.

Evaluating the Coronary Artery Disease Consortium Model and the Coronary Artery Calcium Score in Predicting Obstructive Coronary Artery Disease in a Symptomatic Mixed Asian Cohort.

Background The utility of a given pretest probability score in predicting obstructive coronary artery disease (CAD) is population dependent. Previous studies investigating the additive value of coronary artery calcium (CAC) on pretest probability scores were predominantly limited to Western populations. This retrospective study seeks to evaluate the CAD Consortium (CAD2) model in a mixed Asian cohort within Singapore with stable chest pain and to evaluate the incremental value of CAC in predicting obstructive CAD.

Clinical TNM staging for esophageal, gastric, and colorectal cancers in the era of neoadjuvant therapy: A systematic review of the literature.

Aim: Clinical staging is vital for selecting appropriate candidates and designing neoadjuvant treatment strategies for advanced tumors. The aim of this review was to evaluate diagnostic abilities of clinical TNM staging for gastrointestinal, gastrointestinal cancers.

Methods: We conducted a systematic review of recent publications to evaluate the accuracy of diagnostic modalities on gastrointestinal cancers.

Relationship between the degree of renal dysfunction and the safety and efficacy outcomes in patients with atrial fibrillation receiving direct oral anticoagulants.

Background: The clinical evaluation of a direct oral anticoagulant (DOAC) treatment for atrial fibrillation (AF) patients with renal dysfunction has not been sufficiently studied. This study aimed to evaluate the safety and efficacy of DOACs for patients with a severely impaired renal function.

Methods: This was a retrospective and observational study in a single center.

A novel and simple scoring system for assessing the indication for catheter ablation in patients with atrial fibrillation: The HEAL-AF Score.

Introduction: A scoring system to determine indications for catheter ablation (CA) in atrial fibrillation (AF) is desired.

Methods And Results: Among 2898 consecutive patients with AF, CA was performed in 938 (32.4%).

Squamous cell transformation as a mechanism of acquired resistance to tyrosine kinase inhibitor in EGFR-mutated lung adenocarcinoma: a report of two cases.

Pathological transformation to squamous cell carcinoma after epidermal growth factor receptor ()-tyrosine kinase inhibitor treatment has been reported, but details of the transformation remain unclear. We report two cases with transformation to squamous cell carcinoma. The first case was a 61-year-old man who was an ex-smoker with stage IV lung adenocarcinoma harbouring exon 19 insertion.

Evaluation of oral anticoagulants in atrial fibrillation patients over 80 years of age with nonsevere frailty.

Background: The safety and efficacy of an oral anticoagulant (OAC) treatment and the difference between direct OACs (DOACs) and warfarin in nonsevere frail elderly patients with AF are unclear.

Methods: This was a retrospective and observational study of 354 patients over 80 years of age with nonsevere frailty who were diagnosed with AF and treated with OACs. Nonsevere frailty was defined as a clinical frailty scale score of <7.

Neurofibromatosis type 1-associated malignant peripheral nerve sheath tumour carcinomatous pleurisy: an autopsy case.

A 57-year-old man with neurofibromatosis type 1 (NF-1) and intrathoracic meningoceles was admitted to hospital after presenting with neck pain and progressive dyspnoea. On admission, a chest computed tomography scan demonstrated right pleural effusion, neck tumour, intrathoracic meningoceles, and rib metastasis. The myelography showed no transportation between the intrathoracic meningoceles and pleural cavity.

Current status of postoperative infections after digestive surgery in Japan: The Japan Postoperative Infectious Complications Survey in 2015.

Aim: To survey postoperative infections (PI) after digestive surgery.

Methods: This survey, conducted by the Japan Society of Surgical Infection, included patients undergoing digestive surgery at 28 centers between September 2015 and March 2016. Data collected included patient background characteristics, type of surgery, contamination status, and type of PI, including surgical site infection (SSI), remote infection (RI), and antimicrobial-resistant (AMR) bacterial infections and colonization.

Impact of electrophysiological and pharmacological noninducibility following pulmonary vein isolation in patients with paroxysmal and persistent atrial fibrillation.

Background: Two methods for testing inducibility of atrial fibrillation (AF)-atrial pacing and isoproterenol infusion-have been proposed to determine the endpoint of catheter ablation. However, the utility of the combination for testing electrophysiological inducibility (EPI) and pharmacological inducibility (PHI) is unclear.

Methods: After pulmonary vein isolation (PVI), inducibility of atrial tachyarrhythmia was assessed with the dual methods in 291 consecutive patients with AF (65% paroxysmal) undergoing initial catheter ablation.

p53 molecular approach to diagnosis and treatment of esophageal squamous cell carcinoma.

We reviewed our research concerning p53 molecules in esophageal squamous cell carcinoma by focusing on the p53 molecular diagnosis and treatment of esophageal squamous cell carcinoma. First, we developed diagnostic tools to analyze serum p53 autoantibodies to detect esophageal squamous cell carcinoma. Positive rate was around 25% to 30% in all patients and around 20% even in stage I patients.

Intra-abdominal chemotherapy for peritoneal metastases comes of age?

This editorial mainly discusses perspectives concerning a review paper by Prof. J. Kitayama.

Characteristics of hepatic insulin-sensitive nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) plays a crucial role in type 2 diabetes and hepatocellular carcinoma. The major underlying pathogenesis is hepatic insulin resistance. The aim of the present study was to characterize patients with NAFLD with paradoxically normal hepatic insulin sensitivity relative to patients with NAFLD with hepatic insulin resistance.