665 results match your criteria: "Tsukuba Medical Center[Affiliation]"

Background: Evidence regarding the incidence of prosthesis-patient mismatch (PPM) and long-term mortality after transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is scarce.

Objectives: This study sought to assess the incidence and prognostic impact of PPM after TAVR for bicuspid AS compared with that for tricuspid AS.

Methods: In total, 7,393 patients who underwent TAVR were prospectively enrolled in the OCEAN-TAVI (Optimized Catheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry, an ongoing Japanese, multicenter registry.

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Background: Limited large-scale, real-world data exist on the prevalence and clinical impact of discordance between fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs).

Methods: The J-PRIDE registry (Clinical Outcomes of Japanese Patients With Coronary Artery Disease Assessed by Resting Indices and Fractional Flow Reserve: A Prospective Multicenter Registry) prospectively enrolled 4304 lesions in 3200 patients from 20 Japanese centers. The lesions were classified into FFR+/NHPR-, FFR-/NHPR+, FFR+/NHPR+, or FFR-/NHPR groups according to cutoff values of 0.

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Anticipatory grief is associated with post-bereavement grief; however, reports on the influence of pre-loss depression are limited. Therefore, we investigated the association between the anticipatory grief of family members and post-loss and post-depression grief adjusted for pre-loss depression. This cohort study included the family members of dying patients with cancer.

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Background/aim: Atezolizumab, one of the anti-PD-L1 antibodies, targets PD-L1 expressed on cancer cells and antigen-presenting cells. This immune checkpoint inhibitor is now commonly used in combination with chemotherapy. The objectives of this study were to confirm the treatment outcomes of combined atezolizumab plus chemotherapy, and to identify prognostic factors, with a particular focus on the impact of the site of metastasis in real-world clinical practice.

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In endoscopic endonasal surgery for anterior skull base lesions, maximizing the anterior sphenoidotomy in the superior part is crucial for direct visualization and creating a wide working corridor. Here, we describe a technique we devised that maximizes upper anterior sphenoidotomy while preserving the olfactory mucosa. Laryngoscope, 2024.

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Objective: This study aimed to explore the social factors of patients and caregivers, including those related to their wishes for home-based end-of-life care that influence its fulfillment.

Methods: A secondary analysis was conducted using the dataset (home-based end-of-life care N = 625, hospital end-of-life care N = 7603) Comprehensive patient-based survey conducted by The Study on Quality Evaluation of Hospice and Palliative Care by Bereaved Caregivers (J-HOPE 4) and multivariate analysis (multiple logistic regression) to explore the impact of social factors of patients and caregivers on the fulfillment of home-based end-of-life care. The explanatory variables included 11 social factors of patients, such as age and sex, and 18 social factors of primary caregivers.

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Clinical Outcomes of Endovascular Coil Embolization for Ruptured Middle Cerebral Artery Aneurysms.

J Neuroendovasc Ther

October 2024

Department of Neurosurgery & Stroke, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Objective: Middle cerebral artery (MCA) aneurysms are difficult to treat with coil embolization (CE) due to their location and shape, but the number of CE-treated MCA has gradually increased as treatment techniques have improved. However, the outcomes of CE for ruptured MCA aneurysms are poorly understood. This study aimed to evaluate the outcomes of CE for ruptured MCA aneurysms.

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An 83-year-old man presented with persistent fever after intravesical BCG therapy for bladder cancer. Chest computed tomography (CT) and bronchoscopy revealed diffuse ground-glass opacities with multiple micronodules and lymphocyte-predominant bronchoalveolar lavage fluid with a high CD4/CD8 ratio, respectively. Therefore, corticotherapy for interstitial pneumonia was initiated.

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Most reported cases of large vessel vasculitis (LVV) following coronavirus disease 2019 (COVID-19) have involved adults, with paediatric cases being rare. We present the case of a 14-year-old boy who developed LVV following COVID-19. Initially, he presented with fever and cough, and nasopharyngeal polymerase chain reaction testing confirmed COVID-19.

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Pylephlebitis is a rare infection, characterized by non-specific symptoms such as abdominal pain, that often leads to delayed diagnosis, yet it is a severe infection with a high mortality rate. Imaging studies are essential for diagnosis, and contrast-enhanced abdominal CT and abdominal ultrasound are commonly performed. A 51-year-old male was admitted to the hospital with fever and shock.

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Introduction: Proton beam therapy (PBT) may reduce the number of adverse events in treatment of patients with pediatric cancer. However, it is difficult to evaluate whether the actual therapeutic effect is truly equivalent to that of photon radiotherapy. To compare photon radiotherapy and PBT, a meta-analysis and systematic review were performed.

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Article Synopsis
  • Intraosseous hemangiomas are rare, benign tumors affecting bones, particularly the vertebrae and calvarium, which can cause complications like visual problems and deformities due to their slow growth.
  • A case study of a 10-year-old girl with a recurring giant calvarial hemangioma demonstrated the use of proton beam therapy (PBT) after previous treatments failed, showing positive results.
  • The patient tolerated the PBT well, with minor side effects, and after 14 months, there was a significant reduction in tumor size, suggesting PBT's potential as an effective treatment for difficult cases of hemangiomas in children.
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Purpose: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians'.

Methods: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan.

Results: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%).

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Article Synopsis
  • The study focuses on finding the best screw insertion angles for polyaxial volar locking plates (VLP) to prevent joint penetration in distal radius fractures.
  • Researchers used 30 X-rays and CT scans of healthy wrists to assess the optimal plate positions and their relationship to the transverse diameter of the radius.
  • The findings indicate that the most distal screw position varies with screw angle and increases in proximity to the articular surface as the radius's transverse diameter increases, providing crucial information for preoperative planning.
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Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.

Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.

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Article Synopsis
  • - The study compares the hemodynamic performance and clinical outcomes of self-expandable valves (SEV) and balloon-expandable valves (BEV) in patients with small aortic annulus (SAA) undergoing transcatheter aortic valve replacement (TAVR).
  • - Results showed that SEV offered better hemodynamics, with a higher rate of severe prosthesis-patient mismatch and a greater mean pressure gradient in patients receiving BEV, while BEV had lower incidences of paravalvular leakage and new permanent pacemaker implantation.
  • - Overall, both valve types had similar device success rates, indicating that SEV is superior in hemodynamic outcomes but BEV has advantages in reducing certain complications. *
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Purpose: The objective of this study is to elucidate the current status of procedural radiation doses for endovascular treatment (EVT) of lower extremity artery disease (LEAD) in Japan and to validate the diagnostic reference level (DRL) quantity.

Methods: Survey requests were mailed to 493 facilities across Japan. The study targeted cases of EVT for LEAD performed between April 1, 2020, and March 31, 2022, with a maximum of 10 cases collected per facility.

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Background: This study aimed to investigate prognostic factors for predicting the survival of patients with extensive-disease-stage small-cell lung cancer treated with chemoimmunotherapy.

Methods: Patients were classified according to overall survival (OS): favorable corresponded to an OS ≥ 24 months, moderate corresponded to an OS of 6-24 months, and poor corresponded to an OS < 6 months. Multivariate Cox regression analyses were used to evaluate prognostic factors.

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Identification of causative and non-causative microorganisms of nephrostomy tube-associated pyelonephritis among patients with malignancy.

J Infect Chemother

November 2024

Division of Infectious Diseases, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Article Synopsis
  • Prolonged nephrostomy tube use can lead to nephrostomy tube-associated pyelonephritis (NTAP) in patients with malignancies, but data on NTAP characteristics in this group are limited.
  • A study analyzed 43 NTAP cases, identifying causative microorganisms primarily as E. coli and Klebsiella pneumoniae, with specific non-causative organisms like certain enterococci and Candida species.
  • Treatment with antimicrobials for 7 days resulted in recovery for most patients, indicating that not all detected microorganisms require immediate treatment, particularly those resistant to cephalosporins.
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Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.

Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.

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Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement with Evolut FX up until October 2023.

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Article Synopsis
  • East Asians typically have smaller aortic valve complexes compared to Western populations, and there’s limited data on TAVI outcomes in Asian patients with large annuli.
  • This study analyzes TAVI results in Asian patients, comparing outcomes between balloon-expandable valves (BEVs) and self-expandable valves (SEVs) by examining data from the OCEAN-TAVI registry.
  • Findings show no significant differences in 3-year all-cause mortality, heart failure rehospitalization rates, or valve function after 2 years between BEV and SEV groups, although SEVs had higher rates of paravalvular leakage and pacemaker implantation.
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Article Synopsis
  • * He was diagnosed with acute heart failure and infective endocarditis (IE), but due to his age and surgical history, surgery was deemed too risky.
  • * Instead of surgery, the team performed lead extraction, inserted a leadless pacemaker, and provided antimicrobial therapy, leading to the patient's discharge after 48 days, showcasing a less invasive strategy for treating device-related infections.
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Preoperative planning is important for the osteosynthesis of distal radius fractures. Challenges arise for patients presenting with bilateral wrist injuries or a history of contralateral wrist injuries. In such cases, the estimation of the distal radius morphology and the determination of the plate size from the preoperative physical characteristics could prove beneficial.

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