Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan.

: Although chronic infection by among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. : This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients' backgrounds.

Cost-effectiveness analysis of 9-valent human papillomavirus vaccine combined with screening for cervical cancer in Japan.

Objective: In Japan, the current coverage rate of human papillomavirus (HPV) vaccination is only 30%, and the rate of biennial cervical screening is 40%. The Japanese Government has attempted to increase the coverage of HPV vaccination and cervical screening. We analyzed the cost-effectiveness of the 9-valent HPV vaccine and cervical screening in Japan.

Exploring the impact of perioperative analgesia on postoperative chronic analgesic prescriptions in patients with lung cancer undergoing minimally invasive thoracic surgery: A retrospective observational study.

Background: Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS).

Clinical course and management of pediatric gastroduodenal perforation beyond neonatal period.

Background: The treatments and outcomes of pediatric gastroduodenal perforations have rarely been described.

Methods: We retrospectively identified 515 patients aged 28 days to 17 years who were hospitalized for gastroduodenal perforation between July 2010 and March 2021 using a nationwide inpatient database. We compared characteristics, treatments, and outcomes for pediatric gastroduodenal perforation between children aged <7 years (n = 38) and ≥7 years (n = 477).

Machine Learning Prediction for Postdischarge Falls in Older Adults: A Multicenter Prospective Study.

Objectives: The study aimed to develop a machine learning (ML) model to predict early postdischarge falls in older adults using data that are easy to collect in acute care hospitals. This may reduce the burden imposed by complex measures on patients and health care staff.

Design: This prospective multicenter study included patients admitted to and discharged from geriatric wards at 3 university hospitals and 1 national medical center in Japan between October 2019 and July 2023.

Impact of board-certified intensive care training facilities on choice of adjunctive therapies and prognosis of severe respiratory failure: a nationwide cohort study.

Background: Patients with severe respiratory failure have high mortality and need various interventions. However, the impact of intensivists on treatment choices, patient outcomes, and optimal intensivist staffing patterns is unknown. In this study, we aimed to evaluate treatments and clinical outcomes for patients at board-certified intensive care training facilities compared with those at non-certified facilities.

Association between preoperative antifungal therapy and postoperative complications in patients with pulmonary aspergilloma: A national database study in Japan.

Postoperative complications of pulmonary resection in patients with pulmonary aspergilloma are common. Preoperative antifungal therapy is a perioperative management strategy to reduce postoperative complications; however, the benefit of the treatment remains controversial. A retrospective cohort study was conducted using data from the Diagnosis Procedure Combination database (July 2010-March 2021), a national inpatient database in Japan.

Comparison of open and laparoscopic appendectomy according to the trimester of pregnancy: A nationwide observational study.

Objective: To compare the outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) for acute appendicitis during pregnancy by trimester.

Methods: We conducted a nationwide retrospective cohort study using the Diagnosis Procedure Combination database in Japan. We identified pregnant women diagnosed with appendicitis who underwent OA or LA from 2010 to 2022.

Evaluating endoscopic ultrasound-guided tissue acquisition for diagnosis of small pancreatic neuroendocrine neoplasms.

Although small hypervascular tumors are suspected to be pancreatic neuroendocrine tumors (p-NENs), their diagnosis and treatment are challenging. This study evaluated the usefulness of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for diagnosis of small p-NENs. All p-NEN lesions that underwent EUS-TA at our hospital between April 2018 and December 2023 were retrospectively analyzed.

Clinical Practice and Safety of Endoscopic Balloon Dilation for Crohn's Disease-Related Strictures: A Nationwide Claim Database Analysis in Japan.

Although endoscopic balloon dilation (EBD) is a common therapeutic approach for managing strictures associated with Crohn's disease (CD), the clinical application and complication rates of EBD remain unclear. We collected admission data for patients who underwent EBD using a nationwide database. We compared EBD outcomes between ileal and colonic strictures, CD and ulcerative colitis, and CD and anastomotic strictures arising from cancer-related surgery.

A Retrospective Cohort Study of a Newly Proposed Criteria for Sporadic Creutzfeldt-Jakob Disease.

Background/objectives: Sporadic Creutzfeldt-Jakob disease (sCJD) is a fatal neurodegenerative disorder traditionally diagnosed based on the World Health Organization (WHO) criteria in 1998. Recently, Hermann et al. proposed updated diagnostic criteria incorporating advanced biomarkers to enhance early detection of sCJD.

Comparison of the Safety of Aspirin Monotherapy and Aspirin and P2Y12 Inhibitor Combination Therapy in Patients Post Coil Embolization During Admission: A Cross-Sectional Study Using a Nationwide Inpatient Database.

Background: Some aspects regarding the use of antiplatelet agents after coil embolization for subarachnoid hemorrhage during admission remain unclear. This study used diagnostic procedure combination (DPC) data to investigate the safety and prognostic effects of aspirin monotherapy and aspirin and P2Y12 inhibitor combination therapy on bleeding events.

Methods: This cross-sectional study used Japanese DPC data to assess patients who were hospitalized with subarachnoid hemorrhage and received aspirin monotherapy and aspirin and P2Y12 inhibitor combination therapy between April 2016 and March 2020 (n = 4421).

Effect of a Financial Incentive Scheme for Medication Review on Polypharmacy in Elderly Inpatients With Dementia: A Retrospective Before-and-After Study.

Objectives: Polypharmacy is an important healthcare issue, especially in elderly patients with dementia. As an incentive to reduce polypharmacy, a health insurance reimbursement scheme was introduced in 2016 for medication review and the reduction of medications for inpatients in Japan. However, the effects of these incentive schemes were not evaluated.

Comparison of High-Dose versus Low-Dose Trimethoprim-Sulfamethoxazole for Treating Pneumonia among Hemodialysis Patients: A Nationwide Database Study in Japan.

Hemodialysis patients are at high risk for developing pneumonia (PJP), and trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line agent for treating this disease. However, there is a lack of consensus on the required dosage of TMP-SMX for hemodialysis patients. This study used the nationwide Japanese Diagnosis Procedure Combination database to review hemodialysis patients hospitalized for PJP from April 2014 to March 2022.

Spatiotemporal analysis of the association between Kawasaki disease incidence and PM exposure: a nationwide database study in Japan.

Background: Kawasaki disease (KD) is an acute vasculitis primarily affecting children. While some studies suggest a link between KD and PM exposure, findings remain inconsistent. This study aimed to perform spatiotemporal analysis to investigate the impact of monthly and annual exposure to PM and other air pollutants on the incidence of KD before and after the advent of the COVID-19 pandemic.