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260 results on '"Uotani, Takahiro"'

1. Association of blood group O with a recurrent risk for acute lower gastrointestinal bleeding from a multicenter cohort study

Author

Suzuki, Sho, Tominaga, Naoyuki, Aoki, Tomonori, Sadashima, Eiji, Miike, Tadashi, Kawakami, Hiroshi, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Hikichi, Takuto, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2024
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2. A novel prediction tool for mortality in patients with acute lower gastrointestinal bleeding requiring emergency hospitalization: a large multicenter study

Author

Tominaga, Naoyuki, Sadashima, Eiji, Aoki, Tomonori, Fujita, Minoru, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Hikichi, Takuto, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2024
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3. Characteristics, outcomes, and risk factors of surgery for acute lower gastrointestinal bleeding: nationwide cohort study of 10,342 hematochezia cases

Author

Omori, Jun, Kaise, Mitsuru, Nagata, Naoyoshi, Aoki, Tomonori, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Hikichi, Takuto, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, and Iwakiri, Katsuhiko

Published
2024
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4. Nationwide cohort study identifies clinical outcomes of angioectasia in patients with acute hematochezia

Author

Kobayashi, Mariko, Akiyama, Shintaro, Narasaka, Toshiaki, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Tsuchiya, Kiichiro, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2023
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5. Long-term Risks of Recurrence After Hospital Discharge for Acute Lower Gastrointestinal Bleeding: A Large Nationwide Cohort Study

Author

Sato, Yoshinori, Aoki, Tomonori, Sadashima, Eiji, Nakamoto, Yusuke, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Maehata, Tadateru, Tateishi, Keisuke, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2023
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6. Outcomes and recurrent bleeding risks of detachable snare and band ligation for colonic diverticular bleeding: a multicenter retrospective cohort study

Author

Yamauchi, Atsushi, Ishii, Naoki, Yamada, Atsuo, Kobayashi, Katsumasa, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Mori, Yuki, Osawa, Kazuki, Nakagami, Sota, Kawai, Yuya, Yoshikawa, Takaaki, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2023
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7. Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study

Author

Shiratori, Yasutoshi, Ishii, Naoki, Aoki, Tomonori, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Yamamoto, Kazuki, Yoshimoto, Takaaki, Takasu, Ayaka, Ikeya, Takashi, Omata, Fumio, Fukuda, Katsuyuki, Kaise, Mitsuru, and Nagata, Naoyoshi

Published
2023
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13. Outcomes in high and low volume hospitals in patients with acute hematochezia in a cohort study

Author

Ishii, Naoki, Nagata, Naoyoshi, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kawagishi, Kana, Matsuhashi, Tamotsu, Komaki, Yuga, Miki, Kuniko, Watanabe, Kazuhiro, Omata, Fumio, Shiratori, Yasutoshi, Imamura, Noriatsu, Yano, Takahiko, and Kaise, Mitsuru

Published
2021
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14. High risk stigmata and treatment strategy for acute lower gastrointestinal bleeding: a nationwide study in Japan.

Author

Aoki, Tomonori, Sadashima, Eiji, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, and Fujita, Minoru

Subjects
GASTROINTESTINAL hemorrhage, SUMATRIPTAN, STIGMATIZATION
Abstract

This article discusses a study conducted in Japan on the management and treatment of acute lower gastrointestinal bleeding (ALGIB). The study aims to establish standardized criteria for determining the need for treatment and selecting the appropriate endoscopic treatment method based on factors such as the location, type, and cause of the bleeding. The research analyzes data from a large endoscopy dataset and evaluates the risk of rebleeding, the need for endoscopic treatment, and the choice of treatment based on these factors. The study provides valuable evidence for guiding the management of ALGIB and improving patient outcomes. [Extracted from the article]

Published
2024
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17. Weekend Effect on Clinical Outcomes of Acute Lower Gastrointestinal Bleeding: A Large Multicenter Cohort Study in Japan.

Author

Hayasaka, Junnosuke, Kikuchi, Daisuke, Ishii, Naoki, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, and Fujita, Minoru

Subjects
GASTROINTESTINAL hemorrhage, COHORT analysis, TREATMENT effectiveness, PROPENSITY score matching, VIRTUAL colonoscopy, COMPUTED tomography
Abstract

Introduction: Weekend admissions showed increased mortality in several medical conditions. This study aimed to examine the weekend effect on acute lower gastrointestinal bleeding (ALGIB) and its mortality and other outcomes. Methods: This retrospective cohort study (CODE BLUE-J Study) was conducted at 49 Japanese hospitals between January 2010 and December 2019. In total, 8,120 outpatients with acute hematochezia were enrolled and divided into weekend admissions and weekday admissions groups. Multiple imputation (MI) was used to handle missing values, followed by propensity score matching (PSM) to compare outcomes. The primary outcome was mortality; the secondary outcomes were rebleeding, length of stay (LOS), blood transfusion, thromboembolism, endoscopic treatment, the need for interventional radiology, and the need for surgery. Colonoscopy and computed tomography (CT) management were also evaluated. Results: Before PSM, there was no significant difference in mortality (1.3% vs. 0.9%, p = 0.133) between weekend and weekday admissions. After PSM with MI, 1,976 cases were matched for each admission. Mortality was not significantly different for weekend admissions compared with weekday admissions (odds ratio [OR] 1.437, 95% confidence interval [CI] 0.785–2.630; p = 0.340). No significant difference was found with other secondary outcomes in weekend admissions except for blood transfusion (OR 1.239, 95% CI 1.084–1.417; p = 0.006). Weekend admission had a negative effect on early colonoscopy (OR 0.536, 95% CI 0.471–0.609; p < 0.001). Meanwhile, urgent CT remained significantly higher in weekend admissions (OR 1.466, 95% CI 1.295–1.660; p < 0.001). Conclusion: Weekend admissions decrease early colonoscopy and increase urgent CT but do not affect mortality or other outcomes except transfusion. [ABSTRACT FROM AUTHOR]

Published
2023
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18. Early feeding reduces length of hospital stay in patients with acute lower gastrointestinal bleeding: A large multicentre cohort study.

Author

Kishino, Takaaki, Aoki, Tomonori, Sadashima, Eiji, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, and Fujita, Minoru

Subjects
GASTROINTESTINAL hemorrhage, LENGTH of stay in hospitals, ENDOSCOPIC hemostasis, COHORT analysis, INTERVENTIONAL radiology, HOSPITAL patients
Abstract

Aim: No studies have compared the clinical outcomes of early and delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB). This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved. Methods: We reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE‐J Study). Patients were divided into an early feeding group (≤1 day, n = 3324) and a delayed feeding group (2–3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs. Results: There was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between‐group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p < 0.001). These results were unchanged when subgroups of presumptive and definitive colonic diverticular bleeding were compared. Conclusion: The findings of this nationwide study suggest that early feeding after haemostasis can shorten the hospital stay in patients with ALGIB without increasing the risk of rebleeding. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Development and validation of a novel model for predicting stigmata of recent hemorrhage in acute lower gastrointestinal bleeding: Multicenter nationwide study.

Author

Aoki, Tomonori, Yamada, Atsuo, Kobayashi, Katsumasa, Yamauchi, Atsushi, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, and Sato, Hiroki

Subjects
GASTROINTESTINAL hemorrhage, RECEIVER operating characteristic curves, HEMORRHAGE, STIGMATIZATION, MODEL validation
Abstract

Objectives: Stigmata of recent hemorrhage (SRH) directly indicate a need for endoscopic therapy in acute lower gastrointestinal bleeding (LGIB). Colonoscopy would be prioritized for patients with highly suspected SRH, but the predictors of colonic SRH remain unclear. We aimed to construct a predictive model for the efficient detection of SRH using a nationwide cohort. Methods: We retrospectively analyzed 8360 patients admitted through hospital emergency departments for acute LGIB in the CODE BLUE‐J Study (49 hospitals throughout Japan). All patients underwent inpatient colonoscopy. To develop an SRH predictive model, 4863 patients were analyzed. Baseline characteristics, colonoscopic factors (timing, preparation, and devices), and computed tomography (CT) extravasation were extensively assessed. The performance of the model was externally validated in 3497 patients. Results: Colonic SRH was detected in 28% of patients. A novel predictive model for detecting SRH (CS‐NEED score: ColonoScopic factors, No abdominal pain, Elevated PT‐INR, Extravasation on CT, and DOAC use) showed high performance (area under the receiver operating characteristic curve [AUC] 0.74 for derivation and 0.73 for external validation). This score was also highly predictive of active bleeding (AUC 0.73 for derivation and 0.76 for external validation). Patients with low (0–6), intermediate (7–8), and high (9–12) scores in the external validation cohort had SRH identification rates of 20%, 31%, and 64%, respectively (P < 0.001 for trend). Conclusions: A novel predictive model for colonic SRH identification (CS‐NEED score) can specify colonoscopies likely to achieve endoscopic therapy in acute LGIB. Using the model during initial management would contribute to finding and treating SRH efficiently. [ABSTRACT FROM AUTHOR]

Published
2023
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22. Multicenter propensity score‐matched analysis comparing short versus long cap‐assisted colonoscopy for acute hematochezia.

Author

Kobayashi, Mariko, Akiyama, Shintaro, Narasaka, Toshiaki, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, and Uotani, Takahiro

Subjects
COLONOSCOPY, PROPENSITY score matching, BLOOD transfusion, TELERADIOLOGY, INTERVENTIONAL radiology
Abstract

Background and Aim: While short and long attachment caps are available for colonoscopy, it is unclear which type is more appropriate for stigmata of recent hemorrhage (SRH) identification in acute hematochezia. This study aimed to compare the performance of short versus long caps in acute hematochezia diagnoses and outcomes. Methods: We selected 6460 patients who underwent colonoscopy with attachment caps from 10 342 acute hematochezia cases in the CODE BLUE‐J study. We performed propensity score matching (PSM) to balance baseline characteristics between short and long cap users. Then, the proportion of definitive or presumptive bleeding etiologies found on the initial colonoscopy and SRH identification rates were compared. We also evaluated rates of blood transfusions, interventional radiology, or surgery, as well as the rate of rebleeding and mortality within 30 days after the initial colonoscopy. Results: A total of 3098 patients with acute hematochezia (1549 short cap and 1549 long cap users) were selected for PSM. The rate of colonic diverticular bleeding (CDB) diagnosis was significantly higher in long cap users (P = 0.006). While the two groups had similar rates of the other bleeding etiologies, the frequency of unknown etiologies was significantly lower in long cap users (P < 0.001). The rate of SRH with active bleeding was significantly higher in long cap users (P < 0.001). Other clinical outcomes did not differ significantly. Conclusion: Compared to that with short caps, long cap‐assisted colonoscopy is superior for the diagnosis of acute hematochezia, especially CDB, and the identification of active bleeding. [ABSTRACT FROM AUTHOR]

Published
2023
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37. Effectiveness and adverse events of endoscopic clipping versus band ligation for colonic diverticular hemorrhage: a large-scale multicenter cohort study.

Author

Kobayashi, Katsumasa, Nagata, Naoyoshi, Furumoto, Yohei, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Kishino, Takaaki, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, and Fujita, Minoru

Subjects
RESEARCH, COLONOSCOPY, GASTROINTESTINAL hemorrhage, ENDOSCOPIC hemostasis, TREATMENT effectiveness, COLON diverticulum, LONGITUDINAL method, LIGATURE (Surgery), DISEASE complications
Abstract

BACKGROUND : Prior studies have shown the effectiveness of both endoscopic band ligation (EBL) and clipping for colonic diverticular hemorrhage (CDH) but have been small and conducted at single centers. Therefore, we investigated which was the more effective and safe treatment in a multicenter long-term cohort study. METHODS : We reviewed data for 1679 patients with CDH who were treated with EBL (n = 638) or clipping (n = 1041) between January 2010 and December 2019 at 49 hospitals across Japan (CODE BLUE-J study). Logistic regression analysis was used to compare outcomes between the two treatments. RESULTS : In multivariate analysis, EBL was independently associated with reduced risk of early rebleeding (adjusted odds ratio [OR] 0.46; P < 0.001) and late rebleeding (adjusted OR 0.62; P < 0.001) compared with clipping. These significantly lower rebleeding rates with EBL were evident regardless of active bleeding or early colonoscopy. No significant differences were found between the treatments in the rates of initial hemostasis or mortality. Compared with clipping, EBL independently reduced the risk of needing interventional radiology (adjusted OR 0.37; P = 0.006) and prolonged length of hospital stay (adjusted OR 0.35; P < 0.001), but not need for surgery. Diverticulitis developed in one patient (0.16 %) following EBL and two patients (0.19 %) following clipping. Perforation occurred in two patients (0.31 %) following EBL and none following clipping. CONCLUSIONS : Analysis of our large endoscopy dataset suggests that EBL is an effective and safe endoscopic therapy for CDH, offering the advantages of lower early and late rebleeding rates, reduced need for interventional radiology, and shorter length of hospital stay. [ABSTRACT FROM AUTHOR]

Published
2022
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41. Dual Therapy with Vonoprazan and Amoxicillin Is as Effective as Triple Therapy with Vonoprazan, Amoxicillin and Clarithromycin for Eradication of Helicobacter pylori.

Author

Furuta, Takahisa, Yamade, Mihoko, Kagami, Takuma, Uotani, Takahiro, Suzuki, Takahiro, Higuchi, Tomohiro, Tani, Shinya, Hamaya, Yasushi, Iwaizumi, Moriya, Miyajima, Hiroaki, Umemura, Kazuo, Osawa, Satoshi, and Sugimoto, Ken

Subjects
AMOXICILLIN, HELICOBACTER pylori, CLARITHROMYCIN, H2 receptor antagonists, PROPENSITY score matching, PROTON pump inhibitors
Abstract

Backgrounds/Aims: Vonoprazan (VPZ) is the first clinically available potassium competitive acid blocker. This class of agents provides faster and more potent acid inhibition than proton pump inhibitors. Most strains of Helicobacter pylori are sensitive to amoxicillin. We hypothesized that dual therapy with VPZ and amoxicillin would provide the sufficient eradication rate for H. pylori infection. To evaluate this, we compared the eradication rate by the dual VPZ/amoxicillin therapy with that by the standard triple VPZ/amoxicillin/clarithromycin therapy. Methods: Non-inferiority of the eradication rate of H. pylori by the dual therapy with VPZ 20 mg twice daily (bid) and amoxicillin 500 mg 3 times daily (tid) for 1 week to that by the triple therapy with VPZ 20 mg bid, amoxicillin 750 mg bid and clarithromycin 200 mg bid for 1 week was retrospectively studied. Propensity score matching was performed to improve comparability between 2 regimen groups. Successful eradication was diagnosed using the [13C]-urea breath test at 1–2 months after the end of eradication therapy. Results: The intention-to-treat analysis demonstrated that the eradication rate by the dual therapy (92.9%; 95% CI 82.7–98.0%, 52/56) was not inferior to that of the triple therapy (91.9%; 95% CI 80.4–97.0%, 51/56; OR 1.275, 95% CI 0.324–5.017%, p = 0.728). There were no statistically significant differences in incidences of adverse events between 2 regimens. Conclusion: VPZ-based dual therapy (VPZ 20 mg bid and amoxicillin 500 mg tid for 1 week) provides an acceptable eradication rate of H. pylori infection without the need for second antimicrobial agents, such as clarithromycin. [ABSTRACT FROM AUTHOR]

Published
2020
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42. Randomised trial of acid inhibition by vonoprazan 10/20 mg once daily vs rabeprazole 10/20 mg twice daily in healthy Japanese volunteers (SAMURAI pH study).

Author

Takeuchi, Toshihisa, Furuta, Takahisa, Fujiwara, Yasuhiro, Sugimoto, Mitsushige, Kasugai, Kunio, Kusano, Motoyasu, Okada, Hiroyuki, Suzuki, Takahiro, Higuchi, Tomohiro, Kagami, Takuma, Uotani, Takahiro, Yamade, Mihoko, Sawada, Akinari, Tanaka, Fumio, Harada, Satoshi, Ota, Kazuhiro, Kojima, Yuichi, Murata, Masaki, Tamura, Yasuhiro, and Funaki, Yasushi

Subjects
VOLUNTEERS, PROTON pump inhibitors, UNITS of time, TRANEXAMIC acid
Abstract

Summary: Background: Vonoprazan (V), a potassium‐competitive acid blocker, has a more durable acid‐inhibitory effect as compared with standard‐dose proton pump inhibitors (PPIs) but has not been compared with 2‐4 times higher daily PPI doses administered in two divided doses. Aims: To evaluate the acid‐inhibitory effect of V 10/20 mg once‐daily (OD; V10/V20) vs rabeprazole (R) 10/20 mg twice‐daily (BID; R20/R40) in healthy Japanese volunteers. Methods: This multicentre, randomised, open‐label, two‐period, crossover study compared V10 or V20 vs R20, or V20 vs R40 using three cohorts of 10 healthy Japanese adults. Within each cohort, subjects were randomised to receive V or R for 7 days and, following a washout period ≥7 days, the other treatment for 7 days. On day 6 of each period, 24‐hours multichannel gastric impedance‐pH monitoring was performed. Percent times pH ≥ 3, ≥4 and ≥5 (pH 3, 4 and 5 holding time ratios [HTRs]) in 24 hours were evaluated as primary pharmacodynamic endpoints. Results: Acid‐inhibitory effect (24‐hours pH 3 HTR) of V20 was greater than those of R20 (91.0% vs 65.3%; P =.0049) and R40 (98.5% vs 85.9%; P =.0073). Similar results were obtained for 24‐hours pH 4 and 5 HTRs. V20 also achieved greater nocturnal pH 4 (91.5% vs 73.2%; P =.0319) and 5 HTRs (78.8% vs 62.2%; P =.0325) as compared with R40. One subject (20%) developed diarrhoea while receiving R40 which was considered treatment‐related. Conclusions: Compared with 2‐4 times the standard daily dose of R, V20 exerts a more potent and durable acid‐inhibitory effect. Trial identifier: UMIN000022198 (www.umin.ac.jp/ctr/index.htm). [ABSTRACT FROM AUTHOR]

Published
2020
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44. Prevalence of elevated microsatellite alterations at selected tetranucleotide repeats in pancreatic ductal adenocarcinoma.

Author

Mori, Taiki, Hamaya, Yasushi, Uotani, Takahiro, Yamade, Mihoko, Miyajima, Hiroaki, Sugimoto, Ken, Iwaizumi, Moriya, Furuta, Takahisa, and Osawa, Satoshi

Subjects
MICROSATELLITE repeats, ADENOCARCINOMA, BIOLOGICAL tags, CHEMORECEPTORS, PANCREATIC duct
Abstract

Pancreatic ductal adenocarcinoma (PDAC) prognosis remains poor even after complete resection owing to no valuable biomarkers for recurrence and chemosensitivity. Tumors not expressing MSH3 show elevated microsatellite alterations at selected tetranucleotide repeats (EMAST). EMAST reportedly occurs in several tumors. In colorectal cancer (CRC), EMAST was reportedly correlated with 5-fluorouracil (5-FU) sensitivity. However, EMAST prevalence in PDAC and its significance as a prognostic biomarker are unknown. This study aimed to investigate EMAST prevalence in PDAC and the associations between EMAST and pathological factors, EMAST and prognosis, and EMAST and MSH3 expression via immunohistochemistry (IHC). We assessed 40 PDAC patients undergoing surgery. Genomic DNA was extracted from tumors and normal tissues. EMAST and microsatellite instability-high (MSI-H) were analyzed using five polymorphic tetranucleotide markers and five mononucleotide markers, respectively. Tumor sections were stained for MSH3, and staining intensity was evaluated via the Histoscore (H-score). Eighteen of 40 (45%) PDAC patients were EMAST-positive; however, none were MSI-H-positive. Clinicopathological characteristics including overall survival (OS) and recurrence-free survival (RFS) were not significantly different between EMAST-positive and EMAST-negative patients (P = 0.45, 0.98 respectively). IHC was performed to evaluate MSH3 protein expression levels for the PDAC tissue specimens. H-scores of EMAST-positive patients ranged from 0 to 300 (median, 40) and those of EMAST-negative patients ranged from 0 to 300 (median, 170). MSH3 protein was not significantly downregulated in EMAST-positive patients (P = 0.07). This study is a preliminary study and the number of cases investigated was small, and thus, study of a larger cohort will reveal the clinical implication of EMAST. [ABSTRACT FROM AUTHOR]

Published
2018
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