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1. Assessment of locomotive syndrome in patients with visceral cancer, the comparison with non-cancer patients using propensity score matching

Author

Hiromitsu Takaoka, Yohei Kawasaki, Satoshi Yamaguchi, Masashi Sato, Kazuki Fujimoto, Yasushi Iijima, Shunji Kishida, Yuki Shiko, Junya Saito, Kazuhide Inage, Takuya Miyamoto, Yasuhiro Shiga, Takeshi Yamashita, Mitsuhiro Kitamura, Koki Abe, Sumihisa Orita, Takeo Furuya, Satoshi Maki, Seiji Ohtori, Takahisa Sasho, and Hirotaka Kawano

Subjects
medicine.medical_specialty, business.industry, Non cancer, Psychological intervention, Cancer, Syndrome, Physical function, medicine.disease, Risk Assessment, Cancer treatment, Neoplasms, Internal medicine, Propensity score matching, medicine, Humans, Outpatient clinic, Orthopedics and Sports Medicine, Surgery, In patient, Propensity Score, business, Geriatric Assessment, Locomotion, Aged
Abstract

When treating cancer patients, the progression of symptoms is accompanied by the deterioration of systemic conditions and motor function. From a risk-benefit perspective, a certain level of physical function must be maintained to continue cancer treatment. Recently, outpatient cancer treatment has become more common. Motor function is important to determine the feasibility of continuing cancer treatment. The study aimed to evaluate the motor function of patients with visceral cancer using locomo tests established by Japanese Orthopaedic Association.Locomo tests were performed, and the results were compared with data from non-cancer individuals. Background data were matched by propensity score matching. Data from 53 cancer patients (group C) were compared with that of 75 non-cancer patients (group N).The average score in the two-step test of group C was lower than that of group N (1.27: 1.37, p = 0.004). The average function in the stand-up test of group C was worse than that of group N (p = 0.001). The average score in the 25-question geriatric locomotive function scale (GLFS) of group C was significantly higher than that of group N (19.92: 5.29, SE 2.21, p 0.001). Higher 25-question GLFS scores indicate reduced mobility. The proportion of the locomo stage 2 in group C was significantly higher than in group N (51%: 13%, p 0.001). The results of the two field tests revealed a clinically minimal difference between the two groups, but a statistically significant difference. Locomo tests may be detect potential motor dysfunction in outpatient cancer patients with apparently maintained motor function.Even in cancer patients who attend outpatient clinics, their motor functions could be potentially impaired. Therapeutic interventions to maintain and enhance motor function for cancer patients could be useful for continuing cancer treatment, and furthermore, improving prognosis.

Published
2022

2. What outcomes in community mental health research are important to caregivers of people with schizophrenia? An exploratory qualitative analysis of an online survey

Author

Chiyo Fujii, Takayuki Kawaguchi, Daisuke Nishi, Norito Kawakami, Takuma Shiozawa, Naonori Yasuma, Sayaka Sato, Sosei Yamaguchi, Makiko Abe, Makoto Ogawa, and Momoka Igarashi

Subjects
Pharmacology, medicine.medical_specialty, Schizophrenia (object-oriented programming), behavioral disciplines and activities, Mental health, Psychiatry and Mental health, Clinical Psychology, Qualitative analysis, Mental Health, Caregivers, Surveys and Questionnaires, medicine, Schizophrenia, Humans, Pharmacology (medical), Self Report, Psychiatry, Psychology
Abstract

Objective: This study investigated outcomes in community mental health research that were important to caregivers of people with schizophrenia. Using an online survey conducted from August 1–31, 2020, data were collected from caregivers belonging to the LINE Schizophrenia Family Association. Caregivers identified outcomes important in community mental health research. Two researchers categorized caregivers’ statements into research outcomes.Results: A total of 132 caregivers completed the online self-reported questionnaire, and 296 caregiver statements were identified. Qualitative analysis identified 17 outcome categories. The caregivers tended to value having more free time, maintaining an appropriate relationship with people with schizophrenia, and being able to cope with their symptoms. This exploratory study newly demonstrates the outcomes that caregivers of people with schizophrenia consider important in community mental health research. The findings may be useful in selecting outcomes for future studies of caregivers.

Published
2022

3. Central Line Access Is Predictive of Diagnostic Blood Loss and Transfusion in the Surgical Intensive Care Unit

Author

Anthony O. Okorodudu, Abe DeAnda, Srinivas Polineni, Brian D Adkins, Judy A. Trieu, and Sean G. Yates

Subjects
Central line, medicine.medical_specialty, Blood loss, business.industry, Emergency medicine, Biochemistry (medical), Clinical Biochemistry, Medicine, Surgical intensive care unit, business
Abstract

Background: Diagnostic laboratory testing (DLT) is a source of blood loss in critically ill patients. Approximately half of patients admitted to the intensive care unit (ICU) present with anemia, with the remainder developing a multifactorial anemia with etiologies including central venous catheter (CVC) placement. Consequently, about a third of ICU patients require red blood cell (RBC) transfusion, a practice associated with poorer clinical outcomes. Our objectives were to characterize DLT blood loss in the surgical intensive care unit (SICU), and its relationship with anemia, RBC transfusion, and CVC placement.Methods: An observational study was performed by retrospective chart review of patients admitted to a SICU over 1-year. The number of DLT blood draws, average volume of blood drawn, and estimated discard volume were recorded along with clinical and laboratory findings. Results: A cohort of 292 patients (mean age 62.2 years, male to female ratio 1.5) underwent 299 hospitalizations with an average daily DLT blood loss of 14.3 mL (229.5 mL per admission). Among admissions, 51.2% presented with anemia and 95.3% were anemic at discharge, with 32% of patients receiving an RBC transfusion. Patients with greater DLT-associated blood loss had lower discharge hemoglobin (p=Conclusions: Findings from this study suggest that DLT blood loss contributes to anemia in the SICU and the presence and duration of CVC leads to increased testing, blood loss, anemia, and is predictive of RBC transfusion.

Published
2022

4. Squamous cell carcinoma at the oral commissure in a patient with Behçet's disease

Author

Keigo Kubota, Masanobu Abe, Sayaka Ono, Kazuto Hoshi, and Takahiro Abe

Subjects
medicine.medical_specialty, business.industry, Incidence (epidemiology), Cancer, 030206 dentistry, Disease, Behcet's disease, medicine.disease, Dermatology, Pathology and Forensic Medicine, Lesion, stomatognathic diseases, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, 030220 oncology & carcinogenesis, Carcinoma, medicine, Surgery, Oral Surgery, medicine.symptom, business, Pathological, Stomatitis
Abstract

Lip cancer at the corner of the mouth (i.e., the oral commissure) is considered difficult to detect as the initial lesion, especially in individuals with Behcet's disease (BD), because aphthous stomatitis frequently occurs at the oral commissure of BD patients, but the incidence of cancer at that site is rather low. We present a rare case of oral commissure carcinoma in a 69-year-old Japanese male with BD. The patient's stomatitis had recurred for 10 years, and symptoms of right angular stomatitis had worsened for 2 months. We observed a 10 mm × 6 mm ulcer with induration at the right oral commissure, surrounded by a 20-mm white lesion. The pathological examination of the biopsy sample revealed squamous cell carcinoma. We resected the tumor with the patient under general anesthesia. Although the incidence of carcinoma of the oral commissure is generally low, it is very important to carefully observe patients with BD so that the risk of overlooking this cancer or misdiagnosing it as a recurrent aphthous ulcer is minimized.

Published
2021

5. Rivaroxaban Monotherapy in Patients With Atrial Fibrillation After Coronary Stenting

Author

Tetsuya Matoba, Satoshi Yasuda, Koichi Kaikita, Masaharu Akao, Junya Ako, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui, Hisao Ogawa, Yukihiro Koretsune, Takafumi Hiro, Tetsuya Sumiyoshi, Kazumi Kimura, Yoichiro Hashimoto, Teruyuki Hirano, Hiroyuki Daida, Yasushi Okada, Tsutomu Yamazaki, A. Nakamura, E. Tamiya, T. Yamamoto, S. Suetake, T. Noguchi, S. Nakamura, A. Matsumura, J. Kojima, S. Suwa, H. Yamaguchi, K. Kaikita, T. Yasu, A. Nakajima, T. Yamada, H. Arai, Y. Hata, T. Sakanashi, H. Tateishi, T. Nakayama, Y. Nozaki, M. Akao, Y. Okumura, M. Tokue, N. Kuroki, Y. Maruyama, T. Matoba, N. Hagiwara, H. Suzuki, Y. Nishida, M. Ajioka, K. Yumoto, S. Shimizu, T. Aoyama, H. Shimomura, T. Takeda, K. Oshiro, N. Sugishita, Y. Shibata, T. Otonari, H. Kihara, H. Ogawa, A. Ohno, M. Hazama, M. Shimizu, K. Tsukahara, S. Haruta, T. Wakeyama, T. Haruna, M. Ito, K. Fujii, N. Atsuchi, M. Sata, K. Kimura, N. Hasebe, Y. Kobayasi, K. Ohsato, K. Hironaga, Y. Naganuma, K. Anzaki, K. Oiwa, S. Okazaki, Y. Nakagawa, K. Tokuhiro, K. Tanaka, T. Momose, Y. Fukushima, R. Kametani, K. Kawamitsu, Y. Saito, S. Akashi, K. Kumagai, K. Eshima, T. Tobaru, T. Seo, K. Okuhara, K. Kozuma, Y. Ikari, T. Takahashi, I. Michishita, H. Fujikura, S. Momomura, Y. Yamamoto, K. Otomo, T. Matsubara, H. Tashiro, T. Inoue, M. Ishihara, I. Shiojima, E. Tachibana, J. Ako, K. Sumii, N. Yamamoto, N. Ohmura, T. Nakamura, Y. Morita, N. Takahashi, K. Watanabe, H. Fujinaga, M. Maruyama, T. Oka, T. Shirayama, T. Amano, K. Fukui, K. Ando, S. Oshima, S. Kagiyama, H. Teragawa, M. Yuge, S. Ono, T. Koga, K. Fujiu, M. Kuwabara, Y. Ohya, Y. Yumoto, N. Kuji, M. Ikemura, K. Kario, K. Chatani, K. Sato, H. Miyagi, M. Murakami, K. Saito, M. Hoshiga, S. Sato, N. Kubo, Y. Sakamoto, K. Ashida, H. Sakamoto, S. Murasaki, H. Uehara, T. Akasaka, Y. Ooba, S. Nakahara, Y. Hanaoka, T. Nishimiya, R. Tsunoda, Y. Onuma, S. Higuchi, A. Tani, A. Wada, M. Kato, H. Obata, Y. Higuchi, T. Endo, R. Katou, T. Matsunaga, T. Matsuoka, H. Noguchi, M. Usui, T. Hayashi, Y. Otsuji, T. Osaki, H. Zaizen, H. Yoshihara, K. Kadota, T. Hirose, T. Miyazawa, A. Mori, M. Takano, W. Shimizu, M. Wake, S. Oriso, M. Yoshiyama, S. Kakinoki, T. Nishioka, T. Ozaki, K. Nomoto, K. Seki, K. Kawai, Y. Ozaki, S. Miura, M. Kawasaki, R. Funada, K. Dote, T. Nagano, S. Okamoto, T. Kubo, Y. Murozono, T. Owada, T. Doke, T. Matsumura, M. Horiuchi, A. Takaishi, M. Yamamoto, H. Nakashima, M. Munemasa, Y. Sakata, N. Inoue, T. Ota, Y. Hamano, N. Abe, T. Tsubokura, M. Goto, I. Kubota, M. Yano, K. Umetani, T. Date, H. Morimoto, T. Noda, S. Goto, K. Hibi, A. Nakano, S. Hiramitsu, Y. Kihara, M. Sugi, N. Shiba, D. Izumi, T. Sato, S. Tayama, T. Matsui, A. Suzuki, K. Ajiki, M. Oishi, M. Kiryu, T. Ko, H. Ando, S. Miyazaki, T. Kinugawa, H. Otake, H. Kitaoka, Y. Hirata, S. Honda, M. Manita, Y. Ishii, H. Oka, Y. Nanba, M. Nishino, T. Sakamoto, T. Saito, H. Sakai, M. Ichikawa, S. Namiuchi, K. Inoue, N. Komiyama, Y. Akashi, Y. Nakamura, T. Komaru, T. Hosokawa, T. Chikamori, H. Tanaka, O. Arasaki, K. Aonuma, Y. Wakasa, T. Yoshizawa, T. Sugano, N. Yokota, A. Kakutani, T. Suzuki, Y. Abe, T. Kataoka, H. Okayama, H. Yokoi, K. Chin, K. Hasegawa, H. Tomita, H. Honzyo, H. Kawai, K. Yamamoto, Y. Morino, S. Tsujiyama, S. Hamasaki, Y. Niijima, Y. Mizuno, A. Maki, K. Tanabe, T. Murohara, S. Naomi, M. Arikawa, T. Kato, N. Matsumoto, T. Minamino, H. Sairenji, N. Miyamoto, H. Ito, Y. Matsuura, S. Hata, Y. Nakatsu, T. Onodera, M. Yoshimura, H. Amano, E. Tokutake, M. Kasao, M. Moriguchi, M. Tsuji, H. Yamamoto, Y. Yanbe, T. Iwasawa, M. Suzuki, and H. Mori

Subjects
Rivaroxaban, medicine.medical_specialty, business.industry, Unstable angina, medicine.medical_treatment, Percutaneous coronary intervention, Atrial fibrillation, medicine.disease, Thrombosis, Coronary artery disease, Internal medicine, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Stroke, medicine.drug
Abstract

Objectives The aim of this AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial subgroup analysis was to examine rivaroxaban monotherapy benefits and their relation to the time between stenting and enrollment among patients after coronary stenting. Background Of 2,215 patients with atrial fibrillation and stable coronary artery disease in the AFIRE trial, rivaroxaban monotherapy was noninferior to rivaroxaban plus antiplatelet therapy (combination therapy) in terms of efficacy and superior for safety endpoints. However, thrombotic risk after antiplatelet therapy cessation remained a concern among 1,444 patients who had undergone coronary stenting >1 year before enrollment. Methods The benefits of rivaroxaban monotherapy in coronary stenting subgroups were assessed for efficacy (a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death of any cause), safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria), ischemic endpoints, net adverse clinical event, and time between stenting and enrollment. Results Efficacy and safety endpoints for monotherapy were superior to combination therapy, with HRs of 0.70 for efficacy (95% CI: 0.50-0.98; P = 0.036) and 0.55 for safety (95% CI: 0.33-0.92; P = 0.019). For ischemic endpoints, the HR was 0.82 (95% CI: 0.58-1.15; P = 0.240). The HR became smaller with longer time between stenting and enrollment (efficacy, P for interaction = 0.158; safety, P = 0.097). Conclusions In patients with atrial fibrillation after coronary stenting, the benefits of rivaroxaban monotherapy for efficacy and safety endpoints were consistent with those in the whole AFIRE trial population. The benefits became apparent with longer time between stenting and enrollment. (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease Study [AFIRE]; UMIN000016612 , NCT02642419 )

Published
2021

6. Sudden Cardiac Arrest During the Immediate Revascularization Period in Patients With Non-ST Elevation Myocardial Infarction: A Case Series

Author

Joseph Igwe, Temidayo Abe, Abimbola Chris-Olaiya, Valery S. Effoe, Titilope Olanipekun, Obiorah Egbuche, and Richard Snyder

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Mortality rate, Cardiogenic shock, medicine.medical_treatment, Sudden cardiac arrest, General Medicine, medicine.disease, Revascularization, Thrombosis, medicine.anatomical_structure, Internal medicine, Angiography, Cardiology, Medicine, Myocardial infarction, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Artery
Abstract

Introduction The timing of sudden cardiac arrest (SCA) after myocardial infarction (MI) has been a subject of research because of the impact on preventive strategies. Currently, there is limited data on the risk of SCA in the immediate post revascularization period (≤48 h) in non-ST segment elevation myocardial infarction (NSTEMI). Methods We retrospectively reviewed the electronic medical record system and identified patients who underwent revascularization for NSTEMI at Grady Memorial Hospital, Atlanta, Georgia between January 1st, 2014–December 31st, 2019. We selected patients who had SCA within 48 h of revascularization and evaluated their socio-demographic and inpatient characteristics and outcomes. Results Sixteen (16) cases of SCA in the immediate post revascularization period (within 48 h) were identified and analyzed which corresponds to an incidence rate of 1.8% (n = 16/869). The mean age (SD) was 69 years (14.6) and 75% were males. On angiography , more than 80% of the patients had hemodynamically significant lesions in the left anterior descending arteries and its territories and 50% had multivessel disease. All 16 patients had at least one coronary artery with hemodynamically significant lesion and successfully underwent revascularization. Three-quarter of the patients had a shockable rhythm. The etiology of SCA was in-stent thrombosis in 25% of the patients, cardiogenic shock in 19%, acute respiratory failure in 13% and unknown in 44% of the cases. The 30-day mortality rate was 38%. Conclusion The rate of SCA is high in the first 48 h after MI even with revascularization. Risk stratification for SCA during this critical period may improve outcomes.

Published
2022

7. Isometric Handgrip Stress Test during Right Heart Catheterization in Patients with Mitral Regurgitation -A Case Series Study

Author

Masaharu Akao, Kimihito Minami, Takashi Yoshizawa, Kosuke Doi, Syuhei Ikeda, Moritake Iguchi, Nobutoyo Masunaga, Kenjiro Ishigami, Hisashi Ogawa, Yasuhiro Hamatani, Akiko Fujino, Mitsuru Abe, Mitsuru Ishii, and Yuya Ide

Subjects
Right heart catheterization, Cardiac Catheterization, medicine.medical_specialty, Hemodynamics, Isometric exercise, Ventricular Function, Left, Internal medicine, Internal Medicine, medicine, Humans, In patient, Pulmonary Wedge Pressure, Pulmonary wedge pressure, Aged, Retrospective Studies, Aged, 80 and over, Mitral regurgitation, Ejection fraction, Hand Strength, business.industry, Mitral Valve Insufficiency, Stroke Volume, General Medicine, body regions, Dyspnea, Exercise Test, Cardiology, business, human activities, Case series
Abstract

Objective The severity of mitral regurgitation (MR) dynamically changes during a stress test. Isometric handgrip is a readily-available stress test in daily practice; however, little is known regarding the response to isometric handgrip in MR patients during right heart catheterization. We aimed to evaluate this issue from our case-series study. Methods We retrospectively investigated consecutive MR patients using the isometric handgrip stress test during right heart catheterization at our institution between October 2019 and April 2021. After resting measurements were obtained, sustained maximum-effort hand dynamometer grasping was maintained for about 2-3 minutes. We investigated the differences in right heart catheterization data between at rest and during handgrip, and evaluated the individual response to the isometric handgrip stress test. Results We investigated a total of 15 patients (mean age: 75±6 years, moderate/severe MR: 7/8, primary/secondary MR: 8/7, mean left ventricular ejection fraction: 56±16%, exertional dyspnea: 10). During the handgrip test, the pulmonary capillary wedge pressure (PCWP) significantly increased [9 (8, 13) mmHg at rest to 20 (15, 27) mmHg during handgrip; p0.001]. PCWP changes varied among individuals (range 2-22 mmHg) and were not correlated with patients' backgrounds including age, the natriuretic peptide levels, left ventricular ejection fraction, left atrial diameter or E/e' (all p0.05). Patients with PCWP ≥25 mmHg during handgrip had a higher prevalence of exertional dyspnea than those without [6 (100%) vs. 4 (44%); p=0.04]. Conclusion We observed dynamic and varied hemodynamic changes during isometric handgrip in MR patients, suggesting that further research is needed to evaluate the clinical value of this maneuver.

Published
2022

8. A massive natural disaster, the Great East Japan Earthquake, and the incidence of dialysis due to end-stage kidney disease

Author

Kenichi Yokota, Tadashi Ishii, Hiroshi Ohtomo, Michiaki Abe, Koto Ishizawa, Tetsuya Akaishi, Kazuhiko Orikasa, Takaaki Abe, Atsuko Masaura, Mariko Miyazaki, Hirohisa Shinano, and Shin Takayama

Subjects
Nephrology, medicine.medical_specialty, Natural Disasters, medicine.medical_treatment, Disease, Diabetic nephropathy, Glomerulonephritis, Japan, Renal Dialysis, Internal medicine, Earthquakes, medicine, Humans, Diabetic Nephropathies, Dialysis, Retrospective Studies, business.industry, Incidence, Incidence (epidemiology), Retrospective cohort study, medicine.disease, Kidney Failure, Chronic, business, Kidney disease
Abstract

Background Disaster-related stress can increase blood pressure and the incidence of cardiovascular diseases. However, the role of massive disasters in the development of end-stage kidney disease (ESKD) remains unknown. We investigated the incidence and different causes of dialysis initiation in patients with chronic kidney disease in a city affected by the Great East Japan Earthquake. Methods This was a single-center, retrospective observational study. All patients who initiated or were treated with dialysis at Kesennuma City Hospital between 2007 and 2020 were enrolled. The year of dialysis initiation was retrospectively determined based on the initiation date. The causative renal diseases that led to the need for dialysis initiation were divided into four groups: diabetic nephropathy, hypertensive renal disease, glomerulonephritis, and others. Results Age at dialysis initiation differed significantly among the four groups (p = 0.0262). There was a significant difference in the numbers of the four groups before and after the Great East Japan Earthquake (p = 0.0193). The age of hypertensive renal disease patients was significantly higher than those of patients with diabetic nephropathy (p = 0.0070) and glomerulonephritis (p = 0.0386) after the disaster. The increasing number of dialysis initiations after the Great East Japan Earthquake appeared to be associated with changes in hypertensive renal diseases; the number peaked after 10 years. Conclusions There was an increase in the number of dialysis initiations, especially caused by hypertensive renal diseases, for up to 10 years after the Great East Japan Earthquake. Graphic abstract

Published
2021

9. Discriminatory Value of Self-reported Olfactory Dysfunction in the Prediction of Coronavirus Disease 2019

Author

Ko Onodera, Yoshiko Abe, Motoo Fujita, Yukio Katori, Junichi Tanaka, Yohei Inaba, Takashi Nishioka, Michiaki Abe, Tadashi Ishii, Shin Takayama, Yoko Iwamatsu-Kobayashi, Tetsuya Akaishi, Shigeo Kure, Hiroyuki Imai, Shigeki Kushimoto, Akiko Kikuchi, and Kaoru Igarashi

Subjects
medicine.medical_specialty, Multivariate analysis, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Olfaction Disorders, Internal medicine, Internal Medicine, medicine, Humans, Self report, Close contact, SARS-CoV-2, dysosmia, business.industry, COVID-19, discriminatory value, General Medicine, Predictive value, Dysosmia, Dysgeusia, coronavirus disease 2019 (COVID-19), Original Article, fatigue, Self Report, dysgeusia, medicine.symptom, business
Abstract

Objective Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), remains the world's largest public health concern in 2021. A history of close contact with infectious patients is a factor that predicts a positive SARS-CoV-2 test result. Meanwhile, the precise predictive value of symptoms suggestive of COVID-19 has not been fully elucidated. This study aimed to clarify the predictive and discriminatory value of each clinical symptom suggestive of COVID-19. Methods This study enrolled participants who were tested for SARS-CoV-2 by reverse transcription polymerase chain reaction using a nasopharyngeal swab between November 2020 and January 2021. All enrolled patients were evaluated for data regarding the presence and closeness of contact with infectious patients and comprehensive clinical features (i.e., fever, cough, dyspnea, fatigue, dysosmia, and dysgeusia). Results Among the 1,744 tested participants, 144 tested positive for SARS-CoV-2. In the test-positive group, self-reported cough, fatigue, dysosmia, and dysgeusia were significant predictors of COVID-19, independent from a history of close contact. In particular, the presence of dysosmia was the strongest predictor of COVID-19 in both univariate and multivariate analyses. Among the 42 patients with self-reported dysosmia, 25 (59.5%) were SARS-CoV-2 test-positive. Self-reported dysosmia was reported by 25 (17.4%) of the 144 patients who tested positive for SARS-CoV-2, and 15 (60.0%) of the 25 COVID-19 patients with dysosmia had accompanying dysgeusia. Conclusion The presence of dysosmia was reported by 10-25% of patients with COVID-19, and is a significant predictor of COVID-19 infection, independent from a history of close contact.

Published
2021

10. Delayed cerebral enhancement on post-mortem computed tomography due to residual contrast medium administered shortly before death

Author

Wataru Gonoi, Naomasa Okimoto, Hiroyuki Abe, Masako Ikemura, Masanori Ishida, Tetsuo Ushiku, Noriko Kanemaru, Kotaro Fujimoto, and Osamu Abe

Subjects
medicine.medical_specialty, Resuscitation, Deep gray matter, Encephalopathy, R895-920, Caudate nucleus, Case Report, Postmortem computed tomography, Hypoxic Ischemic Encephalopathy, 030218 nuclear medicine & medical imaging, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, Iodinated contrast, Basal ganglia, Medicine, Radiology, Nuclear Medicine and imaging, Enhancement, business.industry, Hypoxic–ischemic encephalopathy, medicine.disease, Contrast medium, Forensic radiology, Radiology, business, 030217 neurology & neurosurgery
Abstract

Postmortem computed tomography (CT) is currently a well-known procedure and helps in postmortem investigations. In this case report, we report a unique postmortem CT finding: delayed cerebral enhancement associated with the antemortem infusion of contrast medium. A 72-year-old female lost consciousness at a restaurant and was taken to a hospital in an ambulance. Despite resuscitation efforts, she died of hypoxic–ischemic encephalopathy caused by cardiac arrest. About 6 h before her death, she underwent enhanced antemortem CT of the head. No abnormal enhancement was observed in the cerebral parenchyma. Then, 11 h after her death, she underwent unenhanced postmortem CT, which showed bilateral hyperdense caudate nucleus and putamina, due to residual iodinated contrast medium, in addition to other characteristic findings of hypoxic–ischemic encephalopathy. The mechanism underlying this phenomenon could be the destruction of the blood–brain barrier, and/or selective vulnerability, due to hypoxic–ischemic changes in the gray matter. Enhancement of basal ganglia on postmortem CT due to antemortem infusion of iodinated contrast medium might suggest hypoxic–ischemic encephalopathy, which should be noted in postmortem CT interpretations.

Published
2021

11. Successful cochlear implantation in a patient with Epstein syndrome during long-term follow-up

Author

Hidehiko Takeda, Shin-ichi Usami, Takeru Misawa, Tatsuya Yamasoba, Shin-ya Nishio, Kozo Kumakawa, Anjin Mori, Marina Kobayashi, Satoko Abe, and Ryoko Watanabe

Subjects
Pediatrics, medicine.medical_specialty, Hearing Loss, Sensorineural, medicine.medical_treatment, Eltrombopag, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, hemic and lymphatic diseases, Cochlear implant, otorhinolaryngologic diseases, Humans, Medicine, 030223 otorhinolaryngology, business.industry, Autosomal dominant trait, General Medicine, medicine.disease, Cochlear Implantation, Thrombocytopenia, Thrombocytopenic purpura, Cochlear Implants, Otorhinolaryngology, chemistry, Epstein Syndrome, 030220 oncology & carcinogenesis, Female, Surgery, Sensorineural hearing loss, business, Nephritis, Follow-Up Studies, Rare disease
Abstract

Epstein syndrome is a rare disease characterized by macrothrombocytopenia, nephritis and progressive sensorineural hearing loss (SNHL). This syndrome is presently recognized as an autosomal dominant disease caused by mutations of non-muscle myosin heavy chain 9 (MYH9). Little information is available about the progress of SNHL, the efficacy of cochlear implants (CI) or the perioperative management of thrombocytopenia in patients with Epstein syndrome. We herein report a case of a patient with Epstein syndrome with the MYH9:c.2105G>A:p.R702H variant who underwent cochlear implantation after 27 years of follow-up for her progressive SNHL. The deterioration rates of hearing were 3.48 dB/year on the right ear and 2.46 dB/year on the left ear. The patient derived benefits from CI and had a speech recognition test result (for sentences) of 93% at 6-months postoperatively. Thrombocytopenia was successfully managed without any bleeding complications by using eltrombopag, an oral thrombopoietic agent, making transfusion of platelets unnecessary. The accurate diagnosis of Epstein syndrome was made only after long-term follow-up as the thrombocytopenia was initially diagnosed as idiopathic thrombocytopenic purpura. This case report highlights the perioperative management of thrombocytopenia, the progress of SNHL and the potential pitfalls of diagnosis.

Published
2022

12. Albumin-Derived NLR Score is a Novel Prognostic Marker for Esophageal Squamous Cell Carcinoma

Author

Hiroshi Hasegawa, Taro Oshikiri, Tomoki Abe, Hironobu Goto, Takashi Kato, Shingo Kanaji, Hitoshi Harada, Ryuichiro Sawada, Kimihiro Yamashita, Manabu Horikawa, Yoshihiro Kakeji, Naoki Urakawa, and Takeru Matsuda

Subjects
medicine.medical_specialty, Multivariate analysis, Esophageal Neoplasms, Neutrophils, medicine.medical_treatment, Serum albumin, Kaplan-Meier Estimate, Gastroenterology, Internal medicine, Medicine, Humans, Lymphocytes, Serum Albumin, Retrospective Studies, Chemotherapy, biology, Receiver operating characteristic, business.industry, Hazard ratio, Albumin, Prognosis, Confidence interval, Oncology, Esophagectomy, biology.protein, Surgery, Esophageal Squamous Cell Carcinoma, business
Abstract

BACKGROUND Multidisciplinary treatment for esophageal squamous cell carcinoma (ESCC) has improved outcomes, but the prognosis for ESCC remains poor. Nutritional and inflammatory indicators are reported to be associated with cancer prognosis. The combination of albumin and the derived neutrophil-to-lymphocyte ratio (Alb-dNLR) score was established to measure the immune system and nutritional status. The authors hypothesized that the Alb-dNLR score could be a new reliable prognostic factor for ESCC patients. METHODS The study evaluated 269 patients who underwent esophagectomy between April 2010 and March 2018, including 185 patients who received neoadjuvant chemotherapy. The Alb-dNLR score was calculated using serum albumin and the dNLR. The dNLR was calculated as neutrophils to (leukocyte-neutrophil count). The cutoff values of the albumin and dNLR for overall survival (OS) were determined using the receiver operating characteristic curve. Patients were divided into "high" and "low" groups according to the Alb-dNLR score. RESULTS A high Alb-dNLR score was found in 61 cases (22.7%). The 5-year OS was 34% in the high Alb-dNLR group and 66.2% in the low Alb-dNLR group (p < 0.0001). The 5-year cause-specific survival (CSS) was 51.5% in the high Alb-dNLR group and 74.7% in the low Alb-dNLR group (p < 0.0001). Multivariate analyses demonstrated that the Alb-dNLR score was an independent prognostic factor for OS (hazard ratio [HR], 2.198; 95% confidence interval [CI], 1.460-3.263; p = 0.0002) and CSS (HR, 1.733; 95% CI, 1.035-2.835; p = 0.0371). CONCLUSIONS The Alb-dNLR score is an extremely useful, easy-to-use parameter to predict OS and CSS for ESCC patients.

Published
2022

13. Metabolomic and pharmacologic analyses of brain substances associated with sleep pressure in mice

Author

Kazuya Miyanishi, Noriko Hotta-Hirashima, Takaaki Sato, Haruka Suzuki-Abe, Masashi Yanagisawa, Kazuhiro Sonomura, Shinya Nakata, Asmaa Mahmoud, Chika Miyoshi, and Hiromasa Funato

Subjects
medicine.medical_specialty, Carnosine, Protein Serine-Threonine Kinases, Non-rapid eye movement sleep, Mice, chemistry.chemical_compound, Metabolomics, Internal medicine, Metabolome, Animals, Medicine, Wakefulness, business.industry, General Neuroscience, Brain, Electroencephalography, Dipeptides, General Medicine, Sleep in non-human animals, Sleep deprivation, Endocrinology, chemistry, Sleep Deprivation, medicine.symptom, Sleep, business, Homeostasis
Abstract

Sleep pressure, the driving force of the homeostatic sleep regulation, is accumulated during wakefulness and dissipated during sleep. Sleep deprivation (SD) has been used as a method to acutely increase animal’s sleep pressure for investigating the molecular changes under high sleep pressure. However, SD induces changes not only reflecting increased sleep pressure but also inevitable stresses and prolonged wake state itself. The Sik3Sleepy mutant mice (Sleepy) exhibit constitutively high sleep pressure despite sleeping longer, and have been useful as a model of increased sleep pressure. Here we conducted a cross-comparison of brain metabolomic profiles between SD versus ad lib slept mice, as well as Sleepy mutant versus littermate wild-type mice. Targeted metabolome analyses of whole brains quantified 203 metabolites in total, of which 43 metabolites showed significant changes in SD, whereas three did in Sleepy mutant mice. The large difference in the number of differential metabolites highlighted limitations of SD as methodology. The cross-comparison revealed that a decrease in betaine and an increase in imidazole dipeptides are associated with high sleep pressure in both models. These metabolites may be novel markers of sleep pressure at the whole-brain level. Furthermore, we found that intracerebroventricular injection of imidazole dipeptides increased subsequent NREM sleep time, suggesting the possibility that imidazole dipeptides may participate in the regulation of sleep in mice.

Published
2022

14. Paratenon of the cruciate ligaments of the knee: a macroscopic and histological study of human foetuses

Author

Hiroshi Abe, Namiko Sugai, D Suzuki, Gen Murakami, Ji Hyun Kim, José Francisco Rodríguez-Vázquez, and Masahito Yamamoto

Subjects
musculoskeletal diseases, medicine.medical_specialty, Plexus, Histology, Knee Joint, Infrapatellar fat pad, business.industry, Anterior cruciate ligament, Venous plexus, Anatomy, musculoskeletal system, Tendon, Tendons, Tendon sheath, Fetus, medicine.anatomical_structure, Orthopedic surgery, medicine, Ligament, Humans, Anterior Cruciate Ligament, business, human activities
Abstract

Background: The paratenon is a sheath-like connective tissue that allows the tendon to move with minimal friction. The careful removal of the paratenon along the cruciate ligaments is a critical step of knee surgery. Thus, orthopedic surgeons and interventional radiologists consider the paratenon as a basic anatomical tissue along a ligament, not along a tendon. Materials and methods: We performed macroscopic and histological observations of cruciate ligament-associated paratenons in 43 human fetuses. Results: This tissue usually had a thick armor-like appearance that was distant from the infrapatellar fat pad. The anterior cruciate ligament, rather than the posterior ligament, was deeply embedded in the paratenon. The paratenon contained abundant arteries and veins and, at and near the crossing between the cruciate ligaments, had a well-developed venous plexus. Notably, there were abundant fused veins in the paratenon venous plexus, and prenatal knee movements (especially rotation) seemed to restrict its blood supply, leading to the development of a large cavity by way of advancing fusion of veins in the degenerating plexus. This unique manner of cavitation likely expanded the joint cavity. Conclusions: Differences in knee movements in utero seemed to cause differences in the thickness of the paratenon among fetuses. New-borns might have limited knee flexion due to a mass-effect of the thick paratenon around the cruciate ligaments. A slight twisting or rotation at the knee may help to release the knee, because it can break the fetal paratenon and accelerate cavitation.

Published
2022

15. Paravertebral foramen screw fixation for posterior cervical spine surgery: clinical case series

Author

Yosuke Shibao, Hiroshi Takahashi, Toru Funayama, Kosuke Sato, Masao Koda, Tomoaki Shimizu, Fumihiko Eto, Tomoyuki Asada, Mamoru Kono, Tetsuya Abe, Masashi Yamazaki, Kousei Miura, Kentaro Mataki, and Hiroshi Noguchi

Subjects
Cervical spine surgery, medicine.medical_specialty, business.industry, Radiography, General Medicine, musculoskeletal system, Neurovascular bundle, Surgery, Vertebra, Screw fixation, medicine.anatomical_structure, medicine, Foramen, Cervical fusion, Clinical case, business
Abstract

OBJECTIVE The goal of this study was to clarify the clinical utility of paravertebral foramen screws (PVFSs) and to determine intraoperative indicators for appropriate screw placement during posterior cervical fusion surgery to improve its safety. METHODS The authors included data from 46 patients (29 men and 17 women, mean age 61.7 years) who underwent posterior cervical spine surgery with 94 PVFSs. Of the 94 PVFSs, 77 were used in C6, 9 in C3, 5 in C4, and 3 in C5. According to the cervical lateral radiographic view, the authors divided the 94 PVFSs into 3 groups as follows: a longer group, in which the tip of PVFS was located anteriorly from the line of the posterior wall of the vertebral body (> +0 mm); an intermediate group, in which the screw tip was located up to 2 mm posteriorly to the posterior wall of the vertebral body (–2 to 0 mm); and a shorter group, in which the screw tip was located more than 2 mm posteriorly (< –2 mm). The accuracy of screw placement was assessed using CT imaging in the axial plane, and the proportion of screws penetrating a vertebral foramen or a transverse foramen was compared between the 3 groups. Screw loosening was defined as a lucent zone around the screw evaluated on cervical radiography at 1 year after surgery. Complications related to PVFS insertion and revision surgery related to PVFS were evaluated. RESULTS The authors classified 25 PVFSs into the longer group, 43 into the intermediate group, and 26 into the shorter group. The proportion of screws penetrating a vertebral foramen was largest in the shorter group, and the proportion penetrating a transverse foramen was largest in the longer group. Screw loosening was confirmed for 3 of 94 PVFSs. One PVFS inserted in C6 unilaterally within a long construct from C2 to C7 showed loosening, but it did not cause clinical symptoms. Revision surgery was required for 2 PVFSs inserted in C3 bilaterally as the lower instrumented vertebra in occiput–cervical fusion because they pulled out. There was no neurovascular complication related to PVFS insertion. CONCLUSIONS PVFSs are useful for posterior cervical fusion surgery as alternative anchor screws, and the line of the posterior wall of the cervical body on lateral fluoroscopic images is a potential intraoperative reference to indicate an appropriate trajectory for PVFSs.

Published
2022

16. Osteosarcoma of the jaw: Report of four cases

Author

Kana Uchida, Kenji Kawano, Ayaka Abe, Yoshihiro Takahashi, and Tatsuyuki Kono

Subjects
medicine.medical_specialty, business.industry, Epulis, Osteomyelitis, medicine.medical_treatment, Mandible, imaging, Cancer, medicine.disease, Pathology and Forensic Medicine, Radiation therapy, osteoblastic type, jaw, Otorhinolaryngology, osteosarcoma, Maxilla, medicine, Osteosarcoma, Surgery, Radiology, Oral Surgery, Differential diagnosis, business, radiation-induced
Abstract

This paper reports four cases of osteosarcoma of the jaw, a rare malignant bone tumor in the oral and maxillofacial region. Two patients were males and two were females. The age at the first visit ranged 55–69 years (average age, 63.8 years). Three and one patients had a tumor in the mandible and the maxilla, respectively. One mandibular patient had a history of radiotherapy for laryngeal cancer. Radiologically, two cases were of the osteolytic type, and two were of the osteosclerotic type. Two cases of the osteolytic type were diagnosed as malignant tumors, while the other two cases of the osteosclerotic type were as benign lesions (e.g., epulis osteoplastica and osteomyelitis). Pathologically, three and one cases were classified as conventional (osteoblastic type) and secondary (radiation-induced) osteosarcomas, respectively. All patients underwent surgical tumor resection without any adjunctive treatments. Consequently, one patient had no recurrence for 14 years after surgical treatment and the other three had local recurrence and/or distant metastasis, resulting in unfavorable outcomes despite further treatments. Osteosarcoma should be included as a differential diagnosis for bone-forming lesions of the jaw. Furthermore, complete surgical resection combined with adjuvant therapies would be necessary to improve the treatment outcome of jaw osteosarcomas.

Published
2022

17. Characteristic imaging findings predicting the risk of conservative treatment resistance in fresh osteoporotic vertebral fractures with poor prognostic features on magnetic resonance imaging

Author

Toshinori Tsukanishi, Hiroshi Noguchi, Hiroshi Takahashi, Kentaro Mataki, Masashi Yamazaki, Kousei Miura, Masao Koda, Tetsuya Abe, Yosuke Shibao, Kengo Fujii, and Toru Funayama

Subjects
Male, medicine.medical_specialty, Nonunion, Conservative Treatment, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Orthopedics and Sports Medicine, Spinal canal, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Retrospective cohort study, Prognosis, medicine.disease, Magnetic Resonance Imaging, Sagittal plane, Conservative treatment, medicine.anatomical_structure, Delayed union, Spinal Fractures, Female, Surgery, Radiology, Vertebral collapse, business, Osteoporotic Fractures, 030217 neurology & neurosurgery
Abstract

Recent studies have reported that confined high-intensity and diffuse low-intensity on sagittal T2-weighted magnetic resonance imaging (MRI) are distinctive features that are highly predictive of delayed union or nonunion on osteoporotic vertebral fracture (OVF). The objective of this study was to identify the characteristics of imaging findings predicting the risk for requiring surgical treatment in fresh OVF with poor prognostic features on MRI.We conducted a retrospective study of 74 patients (17 men and 57 women with a mean age of 81.1 years) of OVF with the poor prognostic MRI findings. We compared the imaging findings between the surgery group (16 patients) and the conservative group (58 patients): vertebral instability defined as the difference between the vertebral collapse ratio in dynamic X-rays, and the grade of posterior wall injury (Grade I, no spinal canal encroachment; Grade II,2 mm; Grade III, ≥2 mm) as well as the presence or absence of pedicle fracture (Grade I, none; Grade II, unilateral; Grade III, bilateral) on computed tomography.The mean vertebral instability was 24.0% ± 10.1% in the surgery group and 13.0% ± 7.8% in the conservative group, which was significantly different. Posterior wall injury in the surgery and conservative groups was Grade I in 0 and 29 cases, Grade II in 5 and 21 cases, and Grade III in 11 and 8 cases, respectively, constituting a significant difference. Pedicle fracture in the surgery and conservative groups was Grade I in 5 and 55 cases, Grade II in 6 and 2 cases, and Grade III in 5 and 1 case, respectively, also constituting a significant difference.The most high-risk OVF patients with poor prognostic MRI findings who required surgical treatment were those who exhibited greater vertebral instability as well as either more severe posterior wall injury or pedicle fracture.Retrospective clinical study.

Published
2022

18. Alterations in the Duodenal Fluid Microbiome of Patients With Pancreatic Cancer

Author

Marcia I. Canto, Mohamad Dbouk, Eun Ji Shin, Shiro Kohi, Miguel Chuidian, Takeichi Yoshida, Toshiya Abe, Anne Marie Lennon, Anne Macgregor-Das, Michael Borges, and Michael Goggins

Subjects
medicine.medical_specialty, endocrine system diseases, medicine.drug_class, Proton-pump inhibitor, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Pancreatic cancer, Internal medicine, medicine, Humans, Microbiome, Bifidobacterium, Hepatology, medicine.diagnostic_test, biology, business.industry, Microbiota, Fusobacteria, medicine.disease, biology.organism_classification, digestive system diseases, Endoscopy, Pancreatic Neoplasms, medicine.anatomical_structure, Case-Control Studies, 030220 oncology & carcinogenesis, Duodenum, 030211 gastroenterology & hepatology, Pancreatic Cyst, Pancreatic cysts, business, Carcinoma, Pancreatic Ductal
Abstract

Background & Aims The tumor microbiome of patients with pancreas ductal adenocarcinoma (PDAC) includes bacteria normally present in the upper gastrointestinal tract. If the predominant source of intratumoral bacteria in patients with PDAC is retrograde migration from the duodenum, duodenal fluid could be a representative biospecimen for determining microbiome profiles of patients with PDAC or at risk of developing PDAC. Methods We performed a case-control study comparing bacterial and fungal (16S and 18S rRNA) profiles of secretin-stimulated duodenal fluid collections from 308 patients undergoing duodenal endoscopy including 134 normal pancreas control subjects, 98 patients with pancreatic cyst(s) and 74 patients with PDAC. Results Alterations in duodenal fluid microbiomes with diminished alpha diversity were significantly associated with age >70 and proton pump inhibitor use. Patients with PDAC had significantly decreased duodenal microbial alpha diversity compared with age-matched control subjects with normal pancreata and those with pancreatic cyst(s). There was evidence of enrichment of Bifidobacterium genera in the duodenal fluid of patients with PDAC compared with control subjects and those with pancreatic cyst(s). There were also enrichment of duodenal fluid Fusobacteria and Rothia bacteria among patients with PDAC with short-term survival. Duodenal fluid microbiome profiles were not significantly different between control subjects and patients with pancreatic cyst(s). Conclusion Patients with PDAC have alterations in their duodenal fluid microbiome profiles compared with patients with pancreatic cysts and those with normal pancreata. ClinicalTrials.gov , Number: NCT02000089

Published
2022

19. Learning curve of three European centers in laparoscopic, hybrid laparoscopic, and robotic pancreatoduodenectomy

Author

Tobias Keck, Magomet Baychorov, P. Tyutyunnik, Ugo Boggi, Hryhoriy Lapshyn, Francesca Menonna, Ulrich F. Wellner, Sjors Klompmaker, Mark G. Besselink, Abe Fingerhut, Igor Khatkov, Moh'd Abu Hilal, Carlo Lombardo, Roman Izrailov, Niccolò Napoli, Surgery, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, Operative Time, CUSUM, Laparoscopic-assisted surgery, Learning curve, Minimally invasive surgery, Pancreatectomy, Pancreatoduodenectomy, Robot-assisted surgery, Humans, Learning Curve, Pancreaticoduodenectomy, Postoperative Complications, Retrospective Studies, Laparoscopy, Robotic Surgical Procedures, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Blood loss, medicine, Gastric emptying, business.industry, Retrospective cohort study, Surgery, Cohort, 030211 gastroenterology & hepatology, business, Abdominal surgery
Abstract

Introduction: There are limited numbers of high-volume centers performing minimally invasive pancreatoduodenectomy (MIPD) routinely. Several approaches to MIPD have been described. Aim of this analysis was to show the learning curve of three different approaches to MIPD. Focus was on determining the number of cases necessary to obtain proficient level in MIPD. Patients and methods: Retrospective study wherein outcomes of 300 consecutive patients at three centers—at each center the initial 100 consecutive patients undergoing MIPD for malignant and benign tumors of the head of the pancreas and perimpullary area, performed by three experienced surgeons were collected and analyzed. Results: Overall, 300 patients after MIPD were included: the three different cohorts (laparoscopic n = 100, hybrid n = 100, robotic n = 100). CUSUM analysis of operating time in each center demonstrated that the plateau for laparoscopic PD was n = 61, for hybrid PDes was n = 32 and for robotic PD was n = 68. Median operative time for laparoscopic, hybrid, and robotic approaches was 395 min, 404 min, 510 min, respectively. Intraoperative blood loss for laparoscopic PD, hybrid PD, and robotic PD was 250 ml, 250 ml, and 413 ml, respectively. Delayed gastric emptying occurred 12% in laparoscopic cohort, 10% in hybrid, and 53% in robotic cohort. Major complications (Clavien-Dindo III/IV) rate for laparoscopic PD, hybrid PD, and robotic PD was 32%, 37%, and 22% with 5% death in each cohorts, respectively. Conclusion: This analysis of the learning curve of three European centers found a shorter learning curve with hybrid PD as compared to laparoscopic and robotic PD. In implementation of a MIPD program, a stepwise approach might be beneficial.

Published
2022

20. Characteristics of the aortic root morphology in conotruncal anomaly of the congenital heart disease

Author

Yasufumi Kijima, Hiroyuki Kodama, Koichiro Niwa, Yumi Shiina, Naoko Ichikawa, Nobuyuki Komiyama, and Kohei Abe

Subjects
Adult, Heart Defects, Congenital, Male, Aortic valve, Valve-sparing aortic root replacement, medicine.medical_specialty, Transposition of Great Vessels, Aortic Valve Insufficiency, Population, Regurgitation (circulation), Young Adult, Aortic valve replacement, Double outlet right ventricle, Internal medicine, medicine, Humans, education, Aorta, Tetralogy of Fallot, education.field_of_study, business.industry, medicine.disease, medicine.anatomical_structure, Great arteries, Aortic Valve, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Background Aortopathy is a well-known feature of conotruncal anomalies, but it remains unknown whether valve-sparing aortic root replacement, such as the David procedure, is feasible in young patients with severe aortic regurgitation. We assessed the aortic valve complex and aortic root morphology in patients with conotruncal anomalies using echocardiography. Furthermore, we evaluated the relevant factors associated with aortopathy in this population. Methods A total of 172 adult patients with conotruncal anomalies were enrolled in this study. Dimensions of the aortic valve complex were measured at the level of the sinus of Valsalva (SV) and sinotubular junction (STJ). The geometric height (GH), effective height (EH), and coaptation length (CL) were also assessed to analyze the aortic valve complex in detail. Results Sixteen of 172 patients were excluded due to poor imaging; 105 patients with tetralogy of Fallot, 24 with double outlet right ventricle, and 27 with transposition of the great arteries totaling 156 patients (32+/-11 years old) were included in the analysis. The patients were divided into four groups: Group 1 (98 patients) had no dilatation of SV or STJ; Group 2 (32 patients) had dilated SV and STJ; Group 3 (14 patients) had dilated SV; and Group 4 (12 patients) had dilated STJ. GH and EH in Group 2 were also highest among the four, whereas CL was not significantly shortened. Multivariate analysis revealed that male sex, age, and conduit repair were risk factors for aortopathy in this population. Conclusions Patients with dilated SV and STJ (Group 2) were the most common among the patients with aortopathy (Groups 2, 3, and 4). The aortic valve leaflets themselves were enlarged, and the poor coaptation of the valve tips was compensated in spite of aortic root dilatation, which plays an important role in preventing severe aortic regurgitation in this population. Overall, valve-sparing aortic valve replacement is more feasible in the young populations than we expected.

Published
2022

21. Association between race and risk of ICU mortality in mechanically ventilated COVID-19 patients at a safety net hospital

Author

Linda Gamo, Jothika Tamizharasu, Nelson T. Kuete, Nicolas Bakinde, Richard Snyder, Gloria Westney, Temidayo Abe, Titilope Olanipekun, and Timothy Sobukonla

Subjects
medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Safety net, medicine.medical_treatment, Disease, mechanical ventilation, Article, law.invention, law, Humans, Medicine, Retrospective Studies, African Americans, Mechanical ventilation, SARS-CoV-2, business.industry, Mortality rate, COVID-19, General Medicine, Respiration, Artificial, mortality, Intensive care unit, critical care, Intensive Care Units, Respiratory failure, Cohort, Emergency medicine, business, Safety-net Providers
Abstract

Purpose To determine racial differences in intensive care unit (ICU) mortality outcomes among mechanically ventilated patients with severe coronavirus disease 2019 (COVID-19) infection in a safety net hospital. Methods We retrospectively analyzed a cohort of patients ≥ 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease associated respiratory failure who were treated with invasive mechanical ventilation and admitted to the ICU from May 1, 2020 – July 30 -2020 at Grady Memorial Hospital, Atlanta, Georgia – a safety net hospital. We evaluated the association between mortality and demographics, co-morbidities, inpatient laboratory, and radiological parameters. Results Among 181 critically ill mechanically ventilated African American patients treated at a safety net hospital, the mortality rate was 33%. On stratified analysis by race (Table 2), mortality rates were significantly higher in African Americans (39%) and Hispanics (26.3%), compared to Whites (18.9%). On multivariate regression, African Americans were 3 times more likely to die in the ICU compared to Whites (OR 3.1 95% CI 1.6 -5.5). Likewise, the likelihood of mortality was higher in Hispanics compared to Whites (OR 1.3 95% CI 1.0 -3.9). Conclusions Our study demonstrated a high ICU mortality rate in a cohort of mechanically ventilated patients with severe COVID-19 infection treated at a safety net hospital. African Americans and Hispanics had significantly higher risks of ICU mortality compared to Whites. These study findings further elucidate the disproportionately higher burden of COVID-19 infection in African Americans and Hispanics.

Published
2022

22. Lateral Nasal Artery Perforator Flap for Nasal Reconstruction

Author

Shinji Nagasaka, Ichiro Hashimoto, Soushi Ishida, Hiroyuki Yamasaki, Yutaro Yamashita, Yoshiro Abe, and Kazuhide Mineda

Subjects
medicine.medical_specialty, Risk Factors, business.industry, Nose Neoplasms, medicine, Humans, Surgery, Arteries, Nose, Lateral nasal artery, business, Perforator Flap
Abstract

Nasal reconstruction is challenging because of the difficulty in balancing superior aesthetic outcomes and less invasive surgery. The use of the lateral nasal artery (LNA) perforator flap has been reported for nasal reconstruction. However, few reports have described appropriate applications of nasal reconstruction and assessments of nasal deformity. This study aimed to quantify the aesthetic outcomes on using this flap and reveal the risk factors associated with nasal deformities.Twenty patients underwent nasal reconstruction using the LNA flap with a cranial perforator adjacent to the nasal defect. Postoperative protuberant deformities were scored by 2 independent plastic surgeons using a 5-point Likert scale and classified as excellent, good, or poor. The risk factors of deformities were identified using univariate analyses. A nasal alar deviation index was developed to analyze correlations with flap harvesting. The sensory function was assessed by the Semmes-Weinstein test.Flaps survived in 19 patients (95%), and 1 flap showed distal necrosis. All arterial perforators used remained within 5 mm lateral to the boundary between the cheek and nasal ala. The flaps were most often used to cover 2 subunits, including the nasal sidewall defects. Protuberant deformities in 6 (30%), 8 (40%), and 6 (30%) patients were classified as excellent, good, and poor, respectively. Nasal defects involving more than 3 subunits caused severe protuberant deformity. Only 2 patients (5%) in the good and fair groups underwent additional debulking surgery. Nasal alar deviation was not significantly correlated with flap harvesting, when the nasal alar deviation index before and after surgery were compared. Sensory function was retained in all patients.Aesthetic outcomes and sensory function were good on using the LNA perforator flap as a propeller flap having a wide arc of rotation. This flap is suitable for nasal reconstruction involving less than 2 nasal subunits without any severe nasal alar deviation deformity. In addition, this flap allows for better outcomes because it requires less invasive 1-stage surgery.

Published
2022

23. Pancreaticoduodenectomy with Non-Reconstruction of the Remnant Pancreas in Patients with Fat Replacement of the Pancreatic Tail: A Report of Two Cases

Author

Minoru Kitago, Koki Hayashi, Hiroshi Yagi, Shutaro Hori, Go Oshima, Kodai Abe, Yuko Kitagawa, Yuki Masuda, Yuta Abe, Masahiro Shinoda, and Yohei Masugi

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Gastroenterology, Pancreatic tail, medicine, Remnant pancreas, Surgery, In patient, Fat replacement, Pancreaticoduodenectomy, business
Published
2021

24. A Recurrent Case of Adult-onset Still's Disease with Concurrent Acalculous Cholecystitis and Macrophage Activation Syndrome/Hemophagocytic Lymphohistiocytosis Successfully Treated with Combination Immunosuppressive Therapy

Author

Michio Fujiwara, Yuri Kato, Yuri Arai, Kazuya Abe, Yasuhiko Kita, Daijiro Abe, and Yuichi Ishikawa

Subjects
Adult, medicine.medical_specialty, Case Report, adult-onset Still's disease, Disease, 030204 cardiovascular system & hematology, Gastroenterology, Lymphohistiocytosis, Hemophagocytic, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Refractory, hemic and lymphatic diseases, Internal medicine, Internal Medicine, medicine, Humans, Acalculous Cholecystitis, Hemophagocytic lymphohistiocytosis, medicine.diagnostic_test, business.industry, Macrophage Activation Syndrome, General Medicine, medicine.disease, Pancytopenia, Bone marrow examination, hemophagocytic lymphohistiocytosis, Macrophage activation syndrome, Female, 030211 gastroenterology & hepatology, Hemophagocytosis, business, Still's Disease, Adult-Onset, cyclosporine A, Immunosuppressive Agents, hormones, hormone substitutes, and hormone antagonists, Glucocorticoid, medicine.drug
Abstract

We herein report the case of 21-year-old female diagnosed with adult-onset Still's disease (AOSD) three years earlier who presented with fever and right upper abdominal pain. She was diagnosed with acute acalculous cholecystitis (AAC) based on hepatic dysfunction, elevated C-reactive protein, and gallbladder wall thickening on abdominal ultrasound. Based on the presence of pancytopenia, hyperferritinemia, and hemophagocytosis by a bone marrow examination, she was diagnosed with macrophage activation syndrome (MAS)/hemophagocytic lymphohistiocytosis (HLH) which was refractory to glucocorticoid pulse therapy. The combination of intravenous cyclosporine A with glucocorticoids was able to successfully control the disease activity of AOSD-related AAC and MAS/HLH.

Published
2021

25. Stroke prevention in patients from Latin American countries with non‐valvular atrial fibrillation: Insights from the GARFIELD‐AF registry

Author

Jerjes-Sanchez C., Corbalan R., Barretto A. C. P., Luciardi H. L., Allu J., Illingworth L., Pieper K. S., Kayani G., Fitzmaurice D. A., Goto S., Hacke W., Mantovani L. G., Turpie A. G. G., Gersh B. J., Gibbs H., Brodmann M., Cools F., Connolly S. J., Spyropoulos A., Eikelboom J., Hu D., Jansky P., Nielsen J. D., Ragy H., Raatikainen P., Le Heuzey J. -Y., Darius H., Keltai M., Kakkar S., Sawhney J. P. S., Agnelli G., Ambrosio G., Koretsune Y., Diaz C. J. S., ten Cate H., Atar D., Stepinska J., Panchenko E., Lim T. W., Jacobson B., Oh S., Vinolas X., Rosenqvist M., Steffel J., Angchaisuksiri P., Parkhomenko A., Al Mahmeed W., Chen K. N., Zhao Y. S., Zhang H. Q., Chen J. Z., Cao S. P., Wang D. W., Yang Y. J., Li W. H., Yin Y. H., Tao G. Z., Yang P., Chen Y. M., He S. H., Wang Y., Fu G. S., Li X., Wu T. G., Cheng X. S., Yan X. W., Zhao R. P., Chen M. S., Xiong L. G., Chen P., Jiao Y., Guo Y., Xue L., Wang F. Z., Li H., Yang Z. M., Bai C. L., Chen J., Chen J. Y., Chen X., Feng S., Fu Q. H., Gao X. J., Guo W. N., He R. H., He X. A., Hu X. S., Huang X. F., Li B., Li J., Li L., Li Y. H., Liu T. T., Liu W. L., Liu Y. Y., Lu Z. C., Luo X. L., Ma T. Y., Peng J. Q., Sheng X., Shi X. J., Sun Y. H., Tian G., Wang K., Wang L., Wu R. N., Xie Q., Xu R. Y., Yang J. S., Yang L. L., Yang Q., Ye Y., Yu H. Y., Yu J. H., Yu T., Zhai H., Zhan Q., Zhang G. S., Zhang Q., Zhang R., Zhang Y., Zheng W. Y., Zhou B., Zhou Z. H., Zhu X. Y., Jadhav P., Durgaprasad R., Ravi Shankar A. G., Rajput R. K., Bhargava K., Sarma R., Srinivas A., Roy D., Nagamalesh U. M., Chopda M., Kishore R., Kulkarni G., Chandwani P., Pothiwala R. A., Padinhare Purayil M., Shah S., Chawla K., Kothiwale V. A., Raghuraman B., Vijayaraghavan G., Vijan V. M., Bantwal G., Bisne V., Khan A., Gupta J. B., Kumar S., Jain D., Abraham S., Adak D., Barai A., Begum H., Bhattacharjee P., Dargude M., Davies D., Deshpande B., Dhakrao P., Dhyani V., Duhan S., Earath M., Ganatra A., Giradkar S., Jain V., Karthikeyan R., Kasala L., Kaur S., Krishnappa S., Lawande A., Lokesh B., Madarkar N., Meena R., More P., Naik D., Prashanth K., Rao M., Rao N. M., Sadhu N., Shah D., Sharma M., Shiva P., Singhal S., Suresh S., Vanajakshamma V., Panse S. 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O., Oriso S., Ota A., Otaki E., Saito Y., Sakai H., Sakamoto N., Sakamoto Y., Samejima Y., Sasagawa Y., Sasaguri H., Sasaki A., Sasaki T., Sato K., Sawano M., Seki S., Sekine Y., Seta Y., Sezaki K., Shibata N., Shiina Y., Shimono H., Shimoyama Y., Shindo T., Shinohara H., Shinohe R., Shinozuka T., Shirai T., Shiraiwa T., Shozawa Y., Suga T., Sugimoto C., Suzuki K., Suzuki S., Suzuki Y., Tada M., Taguchi A., Takagi T., Takagi Y., Takahashi K., Takahashi S., Takai H., Takanaka C., Take S., Takeda H., Takei K., Takenaka K., Tana T., Tanabe G., Taya K., Teragawa H., Tohyo S., Toru S., Tsuchiya Y., Tsuji T., Tsuzaki K., Uchiyama H., Ueda O., Ueyama Y., Wakaki N., Wakiyama T., Washizuka T., Watanabe M., Yamada T., Yamagishi T., Yamaguchi H., Yamamoto T., Yamaura M., Yamazoe M., Yasui K., Yokoyama Y., Yoshida K., Ching C. K., Foo C. G., Chow J. H., Chen D. D., Jaufeerally F. R., Lee Y. M., Lim G., Lim W. T., Thng S., Yap S. Y., Yeo C., Pak H. N., Kim J. -B., Kim J. H., Jang S. -W., Kim D. H., Ryu D. R., Park S. W., Kim D. -K., Choi D. J., Oh Y. S., Cho M. -C., Kim S. -H., Jeon H. -K., Shin D. -G., Park J. S., Park H. K., Han S. -J., Sung J. H., Cho J. -G., Nam G. -B., On Y. K., Lim H. E., Kwak J. J., Cha T. -J., Hong T. J., Park S. H., Yoon J. H., Kim N. -H., Kim K. -S., Jung B. C., Hwang G. -S., Kim C. -J., Kim D. B., Ahn J. J., An H. J., Bae H., Baek A. L., Chi W. J., Choi E. A., Choi E. H., Choi H. K., Choi H. S., Han S., Heo E. S., Her K. O., Hwang S. W., Jang E. M., Jang H. -S., Jang S., Jeon H. -G., Jeon S. R., Jeon Y. R., Jeong H. K., Jung I. -A., Kim H. J., Kim J. S., Kim J. A., Kim K. T., Kim M. S., Kim S. H., Kim Y. -I., Lee C. S., Lee E. H., Lee G. H., Lee H. Y., Lee H. -Y., Lee K. H., Lee K. R., Lee M. S., Lee M. -Y., Lee R. W., Lee S. E., Lee S. H., Lee S., Lee W. Y., Noh I. K., Park A. R., Park B. R., Park H. N., Park J. H., Park M., Park Y., Seo S. -Y., Shim J., Sim J. H., Sohn Y. M., Son W. S., Son Y. S., Song H. J., Wi H. K., Woo J. J., Ye S., Yim K. H., Yoo K. M., Yoon E. J., Yun S. Y., Chawanadelert S., Mongkolwongroj P., Kanokphatcharakun K., Cheewatanakornkul S., Laksomya T., Pattanaprichakul S., Chantrarat T., Rungaramsin S., Silaruks S., Wongcharoen W., Siriwattana K., Likittanasombat K., Katekangplu P., Boonyapisit W., Cholsaringkarl D., Chatlaong B., Chattranukulchai P., Santanakorn Y., Hutayanon P., Khunrong P., Bunyapipat T., Jai-Aue S., Kaewsuwanna P., Bamungpong P., Gunaparn S., Hongsuppinyo S., Inphontan R., Khattaroek R., Khunkong K., Kitmapawanont U., Kongsin C., Naratreekoon B., Ninwaranon S., Phangyota J., Phrommintikul A., Phunpinyosak P., Pongmorakot K., Poomiphol S., Pornnimitthum N., Pumprueg S., Ratchasikaew S., Sanit K., Sawanyawisuth K., Silaruks B., Sirichai R., Sriwichian A., Suebjaksing W., Sukklad P., Suttana T., Tangsirira A., Thangpet O., Tiyanon W., Vorasettakarnkij Y., Wisaratapong T., Wongtheptien W., Wutthimanop A., Yawila S., Altun A., Ozdogru I., Ozdemir K., Yilmaz O., Aydinlar A., Yilmaz M. B., Yeter E., Ongen Z., Cayli M., Pekdemir H., Ozdemir M., Sucu M., Sayin T., Demir M., Yorgun H., Ersanli M., Okuyan E., Aras D., Abdelrahman H., Aktas O., Alpay D., Aras F., Bireciklioglu M. F., Budeyri S., Buyukpapuc M., Caliskan S., Esen M., Felekoglu M. A., Genc D., Ikitimur B., Karaayvaz E. B., Karatas S. K., Okutucu S., Ozcelik E., Quisi A., Sag H., Sahiner L., Sayin B. Y., Seker T., Alkan D. U., Yildirim E., Yildirim R., Yilmaz F., Yuksekdag V., Vensentini N., Ingaramo A. C., Sambadaro G. A., Caputi V. F., Berman S. G., Dragotto P., Kleiban A. J., Centurion N., Giacomi G., Guerrero R. A. A., Conde D., Zapata G., Di Paola L. A., Ramos J. L., Dran R. D., Egido J., Fernandez A. A., Fosco M. J., Sassone S., Sinisi V. A., Cartasegna L. R., Berli M. A., Vilamajo O. A. G., Ferroni F., Alaguibe E. D., D'Amelio A. A., Arabetti C., Arias L., Belardi J. A., Bergesio L., Berli F., Berli M., Borchowiec S., Buzzetti C., Cabrini R., Campisi V., Cappi A. L., Carrizo R., Berra F. 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K., Braga J. C. F., Negri A., Souto L., Moncada C., Precoma D. B., Roquette F., Reis G., Filho R. A. R., Figueiredo E. L., Botelho R. V., Tavares C. M. D. F., Frack C. R. C., Saad J. A., Finimundi H. C., Pisani C., Chemello D., Martins M. P., Franca C. C. B., Alban F., Rosito G. B. A., Moraes Junior J. B. M. X., Tumelero R. T., Maia L. N., de Almeida R. S., do Carmo Borges N. C., Ferreira L. G. G., Agliardi P., Gomes J. A. O., Araujo V., Nakazone M. A., Barbosa T., Barroso S., Falchetto E. B., Lopes H. B., Lemos M. A. B. T., Biazus G., Queiroz L. B., Camazzola F. E., Caporale M., Cardoso Boscato S., Chieza F., Chokr M. O., Mingireanov R. C., Goes N. C., Correa C., Costa M., Ortiz C. C., da Silva L. S., Paulitsch F. D. S., da Silveira J. A., Daros E., de Araujo G. R., Del Monaco M. I., Dias C., Dias M. A., Wainstein A. P. D., Pizzato P. E., Esteves D. C., Fabri P., Fonseca T. F. L., Fernandes E., Fonseca C., Costantini C. R. F., Ferraz R. 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M., Olguin V., Vergara M., Villan C., Diaz J. I., Cantu R. L., Zavala M. G. R., Jardines R. C., Zavaleta N. E., Umana S. V., Rosas E. L., Esperon G. L., Pozas G., Munoz E. C., Hernandez N. M., Rendon A. L., Hernandez N. G., Ibarra M. L. R., Carrillo L. V., Villezca D. L., Herrera C. H., Prieto J. J. L., Rodriguez R. G., Espinosa E. V., Martinez D. F., Barcena J. V., Yong R., Briones I. R., Pons J. L. L., Lopez H. A., Ruiz R. O., de la Vega C. D., Brito C. C., Valenzuela E. C., Reyes-Sanchez R., Ruiz A. B., Flores O. N., Gonzalez M. B., Nava R. A., Cerda J. D. M., Fierro O. F., Campos P. F., Alfaro T. A. A., Bellorin S. A., Avena R., Chavarria M., Espinosa I., Silva F. F., Nava R. H. G., Godoy K., Felix E. J. G., Garcia C. L. G., Salas L. G. G., Guajardo P., Gonzalez S. H., Izquierdo T., Ortiz M. C. M., Vasquez D. M., Mendoza N., Morales J., Nikitina N., Aybar S. O., Ortiz A., Macias P. P., Perez F., Sanchez J. A. P., Toledano S. P., Gonzalez M. R., Ramos C. R., Castro V. R., Cardona G. R., Cornejo M. R., Salinas A., Santana G., Perez P. S., Castaneda A. C. T., Cortes R. T., Lenz K., Drexel H., Foechterle J., Hagn C., Podczeck-Schweighofer A., Huber K., Winkler M., Schneeweiss B., Gegenhuber A., Lang W., Eichinger-Hasenauer S., Kaserer P., Sykora J., Rasch H., Pichler M., Schaflinger E., Strohmer B., Breier R., Ebner K. -M., Eischer L., Freihoff F., Lischka-Lindner A., Mark T., Mirtl A., Said A., Stocklocker C., Vogel B., Vonbank A., Wohrer C., Zanolin D., Paparella G., Vandergoten P., Parque J. -L., Capiau L., Vervoort G., Wollaert B., Desfontaines P., Mairesse G., Boussy T., Godart P., De Wolf A., Voet J., Heyse A., Hollanders G., Anne W., Vercammen J., Purnode P., Blankoff I., Faes D., Balthazar Y., Beutels M., Marechal P., Verstraete S., Xhaet O., Striekwold H., Thoeng J., Hermans K., Alzand B., Ascoop A. -K., Banaeian F., Barbuto A. -M., Billiaux A. C., Blockmans M., Bouvy C., Brike C., Capiau H., Casier T., Bolado A. C. Y., De Cleen D., De Coninck M., de Vos M., de Weerdt N., Delforge M., Delvigne M., Denie D., Derycker K., Deweerd E., Dormal F., Drieghe S., Everaert M., Eykerman T., Feys E., Ghekiere M., Gits F., Hellemans S., Helvasto L., Jacobs C., Lips S., Mestdagh I., Nimmegeers J., Piamonte V., Pollet P., Postolache A., Raepers M., Raymenants E., Richa J., Rombouts H., Salembier J., Scheurwegs C., Semeraro O., Simons N., Smessaert C., Smolders W., Stockman I., Tahon S., Thyssen V., Tincani G., Van Durme F., Van Lier D., Vandekerckhove H., Vandekerckhove Y., Vandenbroeck D., Vandorpe A., Vanhalst E., Vanhauwaert B., Vantomme C., Vergauwen L., Verloove H., Vydt T., Weyn T., Reichert P., Spacek R., Machova V., Zidkova E., Ludka O., Olsr J., Kotik L., Plocova K., Racz B., Ferkl R., Hubac J., Kotik I., Monhart Z., Burianova H., Jerabek O., Pisova J., Petrova I., Dedek V., Honkova M., Podrazil P., Spinar J., Vitovec J., Novak M., Lastuvka J., Durdil V., Antonova P., Bockova L., Bultas J., Chlumsky J., Dastychova L., Drasnar T., Honek J., Horejsi M., Hubacova V., Janska L., Kopeckova I., Kratochvilova R., Krcova E., Labrova R., Lindourkova A., Lipoldova J., Lubanda H., Ludkova A., Mahdalikova L., Majernikova M., Michalik D., Potuznik P., Prochazkova E., Sulc A., Sveceny J., Valtova M., Zidek M., Zika J., Nielsen H., Husted S., Hintze U., Rasmussen S., Bremmelgaard A., Markenvard J., Boerger J., Solgaard J., Simonsen P., Loekkegaard T., Bruun M., Mertz J., Dominguez H., Skagen K., Egstrup K., Ibsen H., Raymond I., Bang-Hansen T., Ellervik C., Eriksen E., Jensen L., Jensen M., Leth M., Nygaard A., Park J., Schou M., Therkelsen A., Tilma J., Vesterager K., Airaksinen J., Arola O., Koistinen J., Nappila H., Peltomaki K., Rasanen V., Vasankari T., Galinier M., Gottwalles Y., Paganelli F., Loiselet P., Muller J. -J., Koujan M. B., Marquand A., Destrac S., Piot O., Delarche N., Cebron J. -P., Boveda S., Guenoun M., Guedj-Meynier D., Galley D., Ohayon J., Assouline S., Zuber M., Amarenco P., Ellie E., Kadouch J., Fournier P. -Y., Huberman J. -P., Lemaire M., Rodier G., Milandre L., Vandamme X., Sibon I., Neau J. -P., Mahagne M. H., Mielot A., Bonnefoy M., Churet J. -B., Navarre V., Sellem F., Monniot G., Boyes J. -P., Doucet B., Martelet M., Obadia D., Crousillat B., Mouallem J., Bearez E., Nazeyrollas P., Brugnaux J. 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J., Watson, E., Sarai, B., Ahmad, N., Willcock, W., Cairns, J., Sathananthan, S., de Kare-Silver, N., Gilliland, A., Strieder, E., Howitt, A., Vishwanathan, B., Bird, N., Gray, D., Clark, M., Bisatt, J., Litchfield, J., Fisher, E., Fooks, T., Kelsall, A. R., Alborough, E., Wakeling, J., Parfitt, M., Milne, K., Rogers, S., Priyadharshan, R., Oliver, J. L., Davies, E., Abushal, S., Jacobs, M., Hutton, C., Walls, N. I., Thompson, R., Chigbo, C., Zaidi, S. M. A., Howard, M., Butter, K. C., Barrow, S., Little, H., Haq, I. U., Gibbons, L., Glencross, S., Mcleod, A. J., Poland, K., Mulholland, C., Warke, A., Conn, P., Burns, G., Smith, R. N., Lowe, S., Kamath, R., Dau, H. S., Webster, J., Hodgins, I., Vercoe, S., Roome, P. C., Pinnock, H., Patel, J. R. A., Ali, A., Hart, N., Davies, R., Stuart, E., Neden, C. A., Danielsen, M., Heath, R., Sharma, P., Galloway, S., Hawkins, C., Oliver, R., Aylward, M., Mannion, S., Braddick, M., Edwards, D., Rothwell, A. 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Subjects
Registrie, Male, Latin Americans, 030204 cardiovascular system & hematology, outcomes, 0302 clinical medicine, Drug Prescription, Retrospective Studie, Risk Factors, Atrial Fibrillation, Antithrombotic, Prospective Studies, Registries, 030212 general & internal medicine, Practice Patterns, Physicians', Stroke, Anticoagulant, Atrial fibrillation, General Medicine, Middle Aged, Treatment Outcome, Stroke prevention, outcome, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, medicine.drug_class, Clinical Investigations, Hemorrhage, antithrombotic treatment, Drug Prescriptions, 03 medical and health sciences, Internal medicine, medicine, Humans, Mexico, Aged, Retrospective Studies, Fibrillation, business.industry, Risk Factor, Anticoagulants, South America, medicine.disease, Drug Utilization, Clinical trial, Prospective Studie, Latin American, antithrombotic treatment, atrial fibrillation, Latin American, outcomes, business
Abstract

Author(s): Jerjes-Sanchez, Carlos; Corbalan, Ramon; Barretto, Antonio CP; Luciardi, Hector L; Allu, Jagan; Illingworth, Laura; Pieper, Karen S; Kayani, Gloria; GARFIELD-AF Investigators | Abstract: BackgroundAtrial fibrillation (AF) is an important preventable cause of stroke. Anticoagulation (AC) therapy can reduce this risk. However, prescribing patterns and outcomes in patients with non-valvular AF (NVAF) from Latin American countries are poorly described.MethodsUsing data from the Global Anticoagulant Registry in the FIELD-AF (GARFIELD-AF), we examined the stroke prevention strategies and the 1-year outcomes in patients from four Latin American countries: Argentina, Brazil, Chile, and Mexico.ResultsA total of 4162 patients (2010-2014) were included in this analysis. At the time of AF diagnosis, 39.9% of patients were prescribed vitamin K antagonists (VKA) ± antiplatelet (AP) therapy, 21.8% non-VKA oral anticoagulant (NOAC) ± AP, 24.1% AP only and 14.1% no antithrombotic treatment. The proportion of moderate-high risk patients receiving no AC therapy at participating centers was highest in Mexico (46.4%) and lowest in Chile (14.3%). During 1-year follow-up, the rates of all-cause mortality, stroke/SE and major bleeding were: 5.77 (95% CI) (5.06-6.56), 1.58 (1.23-2.02), and 0.99 (0.72-1.36) and per 100 person-years, respectively, which are higher than the global rates across all countries in GARFIELD-AF. Unadjusted rates of all-cause mortality were highest in Argentina, 6.95 (5.43-8.90), and lowest in Chile, 4.01 (2.92-5.52).ConclusionsGARFIELD-AF results describes the marked variation in the baseline characteristics and patterns of antithrombotic treatments in patients with NVAF in four Latin American countries. Over one-third of patients with a moderate-to-high risk of stroke received no AC therapy, highlighting the need for improved management of patients according to national guideline. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362.

Published
2019

26. Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry

Author

Jitendra PS. Sawhney, Veerappa A. Kothiwale, Vikas Bisne, Rajashekhar Durgaprasad, Praveen Jadhav, Manoj Chopda, Velam Vanajakshamma, Ramdhan Meena, Govindan Vijayaraghavan, Kamaldeep Chawla, Jagan Allu, Karen S. Pieper, A. John Camm, Ajay K. Kakkar, Jean-Pierre Bassand, David A. Fitzmaurice, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Lorenzo G. Mantovani, Frank Misselwitz, Alexander G.G. Turpie, Martin van Eickels, Freek W.A. Verheugt, Gloria Kayani, Keith A.A. Fox, Bernard J. Gersh, Hector Lucas Luciardi, Harry Gibbs, Marianne Brodmann, Frank Cools, Antonio Carlos Pereira Barretto, Stuart J. Connolly, Alex Spyropoulos, John Eikelboom, Ramon Corbalan, Dayi Hu, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Sanjay Kakkar, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, D.Y. Hu, K.N. Chen, Y.S. Zhao, H.Q. Zhang, J.Z. Chen, S.P. Cao, D.W. Wang, Y.J. Yang, W.H. Li, Y.H. Yin, G.Z. Tao, P. Yang, Y.M. Chen, S.H. He, Ying Wang, Yong Wang, G.S. Fu, X. Li, T.G. Wu, X.S. Cheng, X.W. Yan, R.P. Zhao, M.S. Chen, L.G. Xiong, P. Chen, Y. Jiao, Y. Guo, L. Xue, F.Z. Wang, H. Li, Z.M. Yang, C.L. Bai, J. Chen, J.Y. Chen, X. Chen, S. Feng, Q.H. Fu, X.J. Gao, W.N. Guo, R.H. He, X.A. He, X.S. Hu, X.F. Huang, B. Li, J. Li, L. 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Y., Angchaisuksiri, P., Chawanadelert, S., Mongkolwongroj, P., Kanokphatcharakun, K., Cheewatanakornkul, S., Laksomya, T., Pattanaprichakul, S., Chantrarat, T., Rungaramsin, S., Silaruks, S., Wongcharoen, W., Siriwattana, K., Likittanasombat, K., Katekangplu, P., Boonyapisit, W., Cholsaringkarl, D., Chatlaong, B., Chattranukulchai, P., Santanakorn, Y., Hutayanon, P., Khunrong, P., Bunyapipat, T., Jai-Aue, S., Kaewsuwanna, P., Bamungpong, P., Gunaparn, S., Hongsuppinyo, S., Inphontan, R., Khattaroek, R., Khunkong, K., Kitmapawanont, U., Kongsin, C., Naratreekoon, B., Ninwaranon, S., Phangyota, J., Phrommintikul, A., Phunpinyosak, P., Pongmorakot, K., Poomiphol, S., Pornnimitthum, N., Pumprueg, S., Ratchasikaew, S., Sanit, K., Sawanyawisuth, K., Silaruks, B., Sirichai, R., Sriwichian, A., Suebjaksing, W., Sukklad, P., Suttana, T., Tangsirira, A., Thangpet, O., Tiyanon, W., Vorasettakarnkij, Y., Wisaratapong, T., Wongtheptien, W., Wutthimanop, A., Yawila, S., Oto, A., Altun, A., Ozdogru, I., Ozdemir, K., Yilmaz, O., Aydinlar, A., Yilmaz, M. 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A., Andersson, A., Malmqvist, L., Martinsson, B., Bernsten, F., Engdahl, J., Thulin, J., Hot-Bjelac, A., Stalby, P., Aaröe, H., Ahbeck, E., Ahlmark, H., Al-Khalili, F., Bonkowski, G., Dzeletovic, S., Ekstrand, A. -B., Eriksson, G. -B., Floren, K., Grässjö, C., Hahn, S., Jaensson, P., Jansson, B., Jansson, J. -H., Kangert, R. -M., Koch, A., Kusiak, D., Lettenström, A., Lindberg, A., Lindholm, C. -J., Mannermyr, A., Mansson, K., Millborg, M., Nilsson, C., Ohlin, A. -M., Olofsson, A., Osberg, A., Pedersen, A., Risbecker, K., Rosenberg, K., Samuelsson, J., Shayesteh, M., Skoglund, K., Stjernberg, M., Thorsen, C., Steffel, J., Beer, J. H., Debrunner, J., Amstutz, D., Bruegger, J., Elise, G., Grau, A., Guinand, A., Henriette, I., Saga, E., Winnik, S., Parkhomenko, A., Rudyk, I., Tseluyko, V., Karpenko, O., Zhurba, S., Kraiz, I., Kupnovytska, I., Serediuk, N., Mostovoy, Y., Ushakov, O., Koval, O., Kovalskyi, I., Svyshchenko, Y., Sychov, O., Stanislavchuk, M., Kraydashenko, O., Yagensky, A., Tykhonova, S., Fushtey, I., Belegai, R., Berko, G., Burdeuna, L., Chabanna, O., Daniuk, I., Ivanov, A., Kamenska, E., Kaplan, P., Khyzhnyak, O., Kizim, S., Matova, O., Medentseva, O., Mochonyi, V., Mospan, M., Nemtsova, V., Ovdiienko, T., Palamarchuk, O., Pavelko, M., Petrovskyy, R., Plevak, D., Proshak, O., Pyvovar, S., Rasputina, L., Romanenko, O., Romanova, O., Sapatyi, A., Shumakov, O., Stets, R., Todoriuk, L., Varenov, V., Fitzmaurice, D., Chauhan, N., Goodwin, D., Saunders, P., Evans, R., Leese, J., Jhittay, P. S., Ross, A., Kainth, M. S., Pickavance, G., Mcdonnell, J., Williams, A., Gooding, T., Wagner, H., Suryani, S., Singal, A., Sircar, S., Bilas, R., Hutchinson, P., Wakeman, A., Stokes, M., Paul, N., Aziz, M., Ramesh, C., Wilson, P., Franklin, S., Fairhead, S., Thompson, J., St Joseph, V., Taylor, G., Tragen, D., Seamark, D., Paul, C., Richardson, M., Jefferies, A., Sharp, H., Jones, H., Giles, C., Page, M., Oginni, O., Aldegather, J., Wetherwell, S., Lumb, W., Evans, P., Scouller, F., Macey, N., Stipp, Y., West, R., Thurston, S., Wadeson, P., Matthews, J., Pandya, P., Gallagher, A., Railton, T., Sinha, B., Russell, D., Davies, J. A., Ainsworth, P., Jones, C. P., Weeks, P., Eden, J., Kernick, D., Murdoch, W., Lumley, L., Patel, R. P., Wong, S. W., Saigol, M., Ladha, K., Douglas, K., Cumberlidge, D. F., Bradshaw, C., Van Zon, G., Jones, K. P., Thomas, M. J., Watson, E., Sarai, B., Ahmad, N., Willcock, W., Cairns, J., Sathananthan, S., de Kare-Silver, N., Gilliland, A., Strieder, E., Howitt, A., Vishwanathan, B., Bird, N., Gray, D., Clark, M., Bisatt, J., Litchfield, J., Fisher, E., Fooks, T., Kelsall, A. R., Alborough, E., Wakeling, J., Parfitt, M., Milne, K., Rogers, S., Priyadharshan, R., Oliver, J. L., Davies, E., Abushal, S., Jacobs, M., Hutton, C., Walls, N. I., Thompson, R., Chigbo, C., Zaidi, S. M. A., Howard, M., Butter, K. C., Barrow, S., Little, H., Haq, I. U., Gibbons, L., Glencross, S., Mcleod, A. J., Poland, K., Mulholland, C., Warke, A., Conn, P., Burns, G., Smith, R. N., Lowe, S., Kamath, R., Dau, H. S., Webster, J., Hodgins, I., Vercoe, S., Roome, P. C., Pinnock, H., Patel, J. R. A., Ali, A., Hart, N., Davies, R., Stuart, E., Neden, C. A., Danielsen, M., Heath, R., Sharma, P., Galloway, S., Hawkins, C., Oliver, R., Aylward, M., Mannion, S., Braddick, M., Edwards, D., Rothwell, A. C., Sabir, A., Choudhary, F., Khalaque, S., Wilson, A., Peters, S., Coulson, W., Roberts, N., Heer, A., Coates, S., Ward, B., Jackson, D., Walton, S., Shepherd, D., Sterry, M., Wong, T., Boon, M., Bunney, R., Haria-Shah, R., Baron, R. T., Davies, S., Schatzberger, T., Hargreaves, N., Stephenson, T., Choi, H., Batson, R., Lucraft, L., Myhill, T., Estifano, S., Geatch, D., Wilkinson, J., Veale, R., Forshaw, K., Davies, T., Zaman, K., Vinson, P., Liley, C., Bandrapalli, M., Mcginty, P., Wastling, R., Mceleny, P., Beattie, A., Cooke, P., Wong, M., Gunasegaram, J., Pugsley, M., Ahmad, S., A'Court, C., Ayers, J., Bennett, J., Cartwright, S., Dobson, S., Dooldeniya, C., Flynn, A., Fox, R., Goram, J., Halpin, A., Hay, A., Jacobs, P., Jeffers, L., Lomax, L., Munro, I., Muvva, R., Nadaph, M., Powell, K., Randfield, S., Redpath, D., Reed, R., Rickenbach, M., Rogers, G., Saunders, P. B., Seamark, C., Shewring, J., Simmons, P., Simper, H., Stoddart, H., Sword, A., Thomas, N., Thomson, A., Gibbs, H., Blenkhorn, A., Singh, B., Van Gaal, W., Abhayaratna, W., Lehman, R., Roberts-Thomson, P., Kilian, J., Coulshed, D., Catanchin, A., Colquhoun, D., Kiat, H., Eccleston, D., French, J., Zimmett, L., Ayres, B., Phan, T., Blombery, P., Crimmins, D., O'Donnell, D., Choi, A., Astridge, P., Arstall, M., Jepson, N., Binnekamp, M., Lee, A., Rogers, J., Starmer, G., Carroll, P., Faunt, J., Aggarwala, A., Barry, L., Batta, C., Beveridge, R., Black, A., Bonner, M., Boys, J., Buckley, E., Campo, M., Carlton, L., Connelly, A., Conway, B., Cresp, D., Dimitri, H., Dixon, S., Dolman, M., Duroux, M., Eskandari, M., Eslick, R., Ferreira-Jardim, A., Fetahovic, T., Fitzpatrick, D., Geraghty, R., Gibbs, J., Grabek, T., Modi, M. H., Hayes, K., Hegde, M. P., Hesketh, L., Hoffmann, B., Jacobson, B., Johnson, K., Juergens, C., Kassam, I., Lawlor, V., Lehman, M., Lehman, S., Leung, D., Mackay, S., Mackenzie, M., Mccarthy, C., Mcintosh, C., Mckeon, L., Morrison, H., Mussap, C., Myers, J. -D., Nagalingam, V., Oldfield, G., O'May, V., Palmer, J., Parsons, L., Patching, K., Patching, T., Paul, V., Plotz, M., Preston, S., Rashad, H., Ratcliffe, M., Raynes, S., Rose, J., Sanders, L., Seremetkoska, M., Setio, H., Shone, S., Shrestha, P., Singh, C., Singleton, C., Stoyanov, N., Sutcliffe, S., Swaraj, K., Tarrant, J., Thompson, S., Tsay, I. M., Vorster, M., Waldman, A., Wallis, L., Wilford, E., Wong, K., Connolly, S. J., Spyropoulos, A., Eikelboom, J., Luton, R., Gupta, M., Pandey, A. S., Cheung, S., Leader, R., Beaudry, P., Ayala-Paredes, F., Berlingieri, J., Heath, J., Poirier, G., Du Preez, M., Nadeau, R., Dresser, G., Dhillon, R., Hruczkowski, T., Schweitzer, B., Coutu, B., Angaran, P., Macdonald, P., Vizel, S., Fikry, S., Parkash, R., Lavoie, A., Cha, J., Ramjattan, B., Bonet, J., Ahmad, K., Aro, L., Aves, T., Beaudry, K., Bergeron, C., Bigcanoe, J., Bignell, N., Breakwell, L., Burke, E., Carroll, L., Clarke, B., Cleveland, T., Daheb, S., Dehghani, P., Denis, I., Djaidani, Z., Dorian, P., Douglass, S., Dunnigan, J., Ewert, A., Farquhar, D., Fearon, A., Ferleyko, L., Fournier, D., Fox, B., Grenier, M. -C., Gulliver, W., Haveman, K., Hines, C., Hines, K., Jackson, A. M., Jean, C., Jethoo, G., Kahlon, R., Kelly, S., Kim, R., Korley, V., Kornder, J., Kwan, L., Largy, J., Lewis, C., Lewis, S., Mangat, I., Moor, R., Navratil, J., Neas, I., Otis, J., Otis, R., Pandey, M., Petrie, F., Pinter, A., Raines, M., Roberts, P., Robinson, M., Sas, G., Schulman, S., Snell, L., Spearson, S., Stevenson, J., Trahey, T., Wong, S., Wright, D., Ragy, H., Abd El-Aziz, A., Abou Seif, S. K., El Din, M. G., El Etriby, S., Elbahry, A., El-Etreby, A., Elkhadem, M., Katta, A., Khairy, T., Mowafy, A., Nawar, M., Ohanissian, A., Reda, A., Reda, M., Salem, H., Sami, N., Samir, S., Setiha, M., Sobhy, M., Soliman, A., Taha, N., Tawfik, M., Zaatout, E., Kettles, D., Bayat, J., Siebert, H., Horak, A., Kelfkens, Y., Garda, R., Pillay, T., Guerra, M., van Zyl, L., Theron, H., Murray, A., Louw, R., Greyling, D., Mntla, P., Ueckermann, V., Loghdey, R., Ismail, S., Ahmed, F., Engelbrecht, J., Ramdass, A., Maharajh, S., Oosthuysen, W., Angel, G., Bester, C., Booysen, M., Boshoff, C., Cannon, C., Cassimjee, S., Chami, C., Conway, G., Davids, A., de Meyer, L., Du Plessis, G., Ellis, T., Henley, L., Karsten, M., Loyd, E., Marks, J., Mavhusa, L., Mostert, M., Page, A., Rikhotso, L., Salie, M., Sasto, J., Shaik, F., Skein, A., Smith, L., Tarr, G., Tau, T., van Zyl, F., Al Mahmeed, W., Yousef, G., Agrawal, A., Nathani, M., Ibrahim, M., Esheiba, E. M., Singh, R., Naguib, A., Abu-Mahfouz, M., Al Omairi, M., Al Naeemi, A., Maruthanayagam, R., Bazargani, N., Wassef, A., Gupta, R., Khan, M., Subbaraman, B., Abdul, A., Al Mulla, A., El Bardisy, S., Haridas, P., Jadhav, S., Magdaluyo, K., Makdad, M., Maqsood, I., Mohamed, R., Sharma, N., Sharma, R., Thanzeel, M., Goldhaber, S. Z., Canosa, R., Rama, P., Blumberg, E., Garcia, J., Mullen, P., Wilson, V., Quick, A., Ferrick, K., Kutayli, W. M., Cox, M., Franco, M., Falkowski, S., Mendelson, R., Williams, M., Miller, S., Beach, S., Alfieri, A., Gutowski, T., Haque, I., Reddy, R., Ahmed, W., Delafontaine, P., Diercks, D., Theodoro, D., Remmel, K., Alberts, M., Ison, R., Noveck, H., Duffy, P., Pitta, S., Nishijima, D., Treasure, C., Asafu-Adjaye, N., Ball, K., Bartlett, M., Bentley, M., Bowers, S., Brown, A., Browne, A., Cameron-Watts, J., Canova, M., Cassidy, D., Cervellione, K., Congal, S., Depauw, J., Dickerson, A., Eley, M., Evans, L., Felpel, S., Ferdinand, K., Fielder, D., Gentry, P., Haideri, A., Hakimi, F., Harbour, T., Hartranft, E., Hawkins, B., Headlee, M., Henson, L., Herrick, C., Hicks, T., Jasinski, S., Jones, A., Jones, L., Jones, P., Karl, S., Keeling, M., Kerr, J., Knowles, P., Langdon, J., Lay, M., Lee, J. A., Lincoln, T., Malone, E., Merliss, A., Merritt, D., Minardo, J., Mooso, B., Orosco, C., Palumbo, V., Parker, M., Parrott, T., Paserchia, S., Pearl, G., Peterson, J., Pickelsimer, N., Purcell, T., Raynor, J., Raziano, S., Richard, C., Richardson, T., Robertson, C., Sage, A., Sanghera, T., Shaw, P., Shoemaker, J., Smith, K., Stephanie, B., Thatcher, A., Theobald, H., Thompson, N., Treasure, L., Tripti, T., Verdi, C., and Worthy, V.

Subjects
Registrie, Male, Time Factors, Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF, 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, Risk Factors, Anticoagulant therapy, Arrhythmia, Atrial fibrillation, GARFIELD-AF, Aged, Atrial Fibrillation, Female, Follow-Up Studies, Humans, Incidence, India, Prevalence, Prognosis, Prospective Studies, Survival Rate, Thromboembolism, Registries, Risk Assessment, Medicine, 030212 general & internal medicine, Prospective cohort study, Incidence (epidemiology), cardiovascular system, medicine.symptom, Cardiology and Cardiovascular Medicine, Risk assessment, Human, medicine.medical_specialty, Time Factor, RD1-811, Prognosi, Follow-Up Studie, 03 medical and health sciences, Internal medicine, Diseases of the circulatory (Cardiovascular) system, cardiovascular diseases, Risk factor, Survival rate, Fibrillation, business.industry, Risk Factor, ta3121, medicine.disease, Clinical trial, Prospective Studie, RC666-701, Surgery, Clinical and Preventive Cardiology, business
Abstract

Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P

Published
2018

27. A case of cutaneous syncytial myoepithelioma with extensive adipocytic metaplasia: Usefulness of <scp>EWSR1</scp> ‐ <scp>PBX3</scp> gene fusion analysis

Author

Shin-ichi Ansai, Tatsuya Katsumi, Takaya Fukumoto, Kanade Shimada, Tokiko Deguchi, Akihiko Yuki, Ryota Hayashi, Hajime Umezu, Mai Nakamura, Osamu Ansai, and Riichiro Abe

Subjects
Pathology, medicine.medical_specialty, Histology, Myoepithelioma, Myoepithelial cell, Dermatology, Biology, Pathology and Forensic Medicine, Fusion gene, Smooth muscle, Pleomorphism (cytology), Metaplasia, Eosinophilic, medicine, Immunohistochemistry, medicine.symptom
Abstract

Cutaneous syncytial myoepithelioma (CSM) is a recently recognized variant of myoepithelial neoplasms. CSM is characterized by an intradermal syncytial proliferation of spindled, ovoid, and histiocytoid cells. Immunohistochemically, tumor cells usually show strong positivity for S-100 and EMA. Here, we report a case of CSM in the thigh of a 51-year-old Japanese woman. Histopathological findings showed a sheet-like growth of ovoid cells and histiocytoid cells with an eosinophilic syncytial cytoplasm, and adipocytic metaplasia was widely observed in the tumor. Immunohistochemical staining revealed a diffuse strong pattern for EMA, smooth muscle actin (SMA), and HHF35 and variable positivity for S-100 protein and p63 in ovoid and histiocytoid cells without significant mitotic figures or pleomorphism. In addition, EWSR1-PBX3 gene fusion, which is characteristic of CSM, was observed in the tumor. Based on these findings, we diagnosed the patient as having CSM. Our case suggests that CSM could show extensive adipocytic metaplasia, which could make its histopathological diagnosis challenging. This article is protected by copyright. All rights reserved.

Published
2022

28. Diabetes Mellitus, Elevated Hemoglobin A1c, and Glycated Albumin Are Associated with the Presence of All-Cause Dementia and Alzheimer’s Disease: The JPSC-AD Study

Author

Moeko, Noguchi-Shinohara, Sohshi, Yuki-Nozaki, Chiemi, Abe, Ayaka, Mori, Mai, Horimoto, Masami, Yokogawa, Natsuko, Ishida, Yukio, Suga, Junko, Ishizaki, Mai, Ishimiya, Hiroyuki, Nakamura, Kiyonobu, Komai, Mao, Shibata, Tomoyuki, Ohara, Jun, Hata, Toshiharu, Ninomiya, and Masahito, Yamada

Subjects
Blood Glucose, Glycation End Products, Advanced, Male, medicine.medical_specialty, endocrine system diseases, Gastroenterology, Prediabetic State, Insulin resistance, Japan, Alzheimer Disease, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Dementia, Glycated Serum Albumin, Prospective Studies, Prediabetes, Risk factor, Vascular dementia, Serum Albumin, Aged, Glycemic, Glycated Hemoglobin, business.industry, General Neuroscience, General Medicine, Odds ratio, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Cross-Sectional Studies, Logistic Models, Hyperglycemia, Multivariate Analysis, Female, Insulin Resistance, Geriatrics and Gerontology, business
Abstract

Background: Glucose dysmetabolism is an important risk factor for dementia. Objective: We investigated the associations of diabetes mellitus, the levels of glycemic measures, and insulin resistance and secretion measures with dementia and its subtypes in a cross-sectional study. Methods: In this study, 10,214 community-dwelling participants were enrolled. Hemoglobin A1c (HbA1c), the homeostasis model assessment (HOMA) for insulin resistance (HOMA-IR), the HOMA of percent β-cell function (HOMA-β), and the glycated albumin (GA) was evaluated. The associations of each measure with Alzheimer’s disease (AD) and vascular dementia (VaD) were investigated. Results: The multivariable-adjusted odds ratios (ORs) of AD were significantly higher in participants with diabetes mellitus than in those without diabetes (1.46 [95% CI: 1.08–1.97]). Higher HbA1c levels were significantly associated with AD at diabetes (≥6.5%) and even at prediabetes (5.7 %–6.4 %) levels; multivariable-adjusted ORs for AD in participants at the diabetes level were 1.72 (95% CI: 1.19–2.49), and those in participants at the prediabetes level were 1.30 (95% CI: 1.00–1.68), compared with those in normal participants. Moreover, higher GA levels were associated with AD. No associations were observed between the diabetic status or the levels of glycemic measures and VaD. In addition, no significant relationships were observed between insulin resistance and secretion measurements and AD and VaD. Conclusion: Our findings indicate that diabetes mellitus and hyperglycemia are significantly associated with AD, even in individuals at the prediabetes level.

Published
2022

29. A case of basilar artery dissection diagnosed with high-resolution MRI

Author

Shingo Mitaki, Masahiro Ueda, Yukie Kanai, Kosuke Asayama, Kentaro Hayashi, Satoshi Abe, Atsushi Nagai, Nao Tahara, Satoshi Inagaki, and Yoshie Kato

Subjects
medicine.medical_specialty, business.industry, medicine.artery, Basilar artery, medicine, High resolution, General Medicine, Dissection (medical), Radiology, medicine.disease, business
Published
2022

30. Imaging of Heart Type Fatty Acid Binding Protein Under Acute Reperfusion Ischemia Using Radio-labeled Antibody in Rat Heart Model

Author

Risako Nakao, Mitsuru Momose, Takahiro Higuchi, Kenji Fukushima, Atsushi Yamamoto, Michinobu Nagao, Yuka Matsuo, Ichiei Kuji, Yoko Kaimoto, Koichiro Abe, and Kazuko Kanaya

Subjects
Cultural Studies, History, medicine.medical_specialty, Literature and Literary Theory, biology, Chemistry, Ischemia, Rat heart, medicine.disease, Endocrinology, Internal medicine, Heart-type fatty acid binding protein, medicine, biology.protein, Original Article, Antibody
Abstract

Purpose: Heart-type fatty acid binding protein (H-FABP) is primary transporter of free fatty acid and plays an important role in myocardial metabolism, which is characterized by high specificity and rapid appearance under ischemic condition. The objective of this study was to clarify the usefulness of imaging study of targeting H-FABP appearance using radio-labeled antibody, and correlation with myocardial fatty acid metabolism and perfusion in acute reperfusion ischemia. Method: Wistar rats were allotted to sham-operated control group (sham; n=4), ischemia non-reperfused group (IG; n=5), and ischemia-reperfusion group (RG; n=5). Ligation of left coronary artery (LCA) was performed for IG and RG. 20 min of ischemia was followed by 60min of reperfusion for RG. (125)I labeled anti H-FABP antibody (anti H-FABP), BMIPP and (99m)Tc-sestamibi (MIBI) was injected intravenously. Multi-tracer digital autoradiogram was performed using µ-imager(®). The ratio of radioactivity in LCA related (culprit) area to the inferior (remote) area (target uptake ratio=TUR) was generated. Results: In sham group, no visually detectable accumulation was observed for the anti H-FABP image, and TUR(MIBI) and TUR(BMIPP) were equivalent to 1. In IG, TUR(MIBI) and TUR(BMIPP) were remarkably low (0.12±0.01, 0.24±0.07). In RG, TUR(MIBI) was significantly lower (0.20±0.03, p

Published
2022

31. First-in-human autologous oral mucosal epithelial sheet transplantation to prevent anastomotic re-stenosis in congenital esophageal atresia

Author

Yasushi Fuchimoto, Yoshiyuki Baba, Akihiro Fujino, Makoto Abe, Katsuhiro Arai, Nobuo Kanai, Masanori Maeda, Takanori Iwata, Nobutaka Isogawa, Akihiro Umezawa, and Ryo Takagi

Subjects
Anastomotic stenosis, medicine.medical_specialty, Medicine (General), Future studies, Medicine (miscellaneous), Constriction, Pathologic, QD415-436, Anastomosis, Epithelial cell sheet, Biochemistry, Genetics and Molecular Biology (miscellaneous), Biochemistry, Balloon dilatation, R5-920, Congenital Esophageal Atresia, medicine, Humans, Child, Esophageal Atresia, Retrospective Studies, business.industry, Research, Mouth Mucosa, Cell sheet transplantation, Regenerative therapy, Cell Biology, First in human, Somatic stem cells, Dysphagia, Re stenosis, Surgery, Transplantation, Treatment Outcome, Esophageal Stenosis, Molecular Medicine, Congenital esophageal atresia, medicine.symptom, business
Abstract

Background Congenital esophageal atresia postoperative anastomotic stricture occurs in 30–50% of cases. Patients with severe dysphagia are treated with endoscopic balloon dilatation (EBD) and/or local injection of steroids, but many patients continue to experience frequent stricture. In this study, we investigated the transplantation of autologous oral mucosa-derived cell sheets (epithelial cell sheets) as a prophylactic treatment for congenital esophageal atresia postoperative anastomotic stricture. Methods Epithelial cell sheets were fabricated from a patient’s oral epithelial tissue, and their safety was confirmed by quality control tests. The epithelial cell sheets were transported under controlled conditions from the fabrication facility to the transplantation facility and successfully transplanted onto the lacerations caused by EBD using a newly developed transplantation device for pediatric patients. The safety of the transplantation was confirmed by follow-up examinations over 48 weeks. Results The dates that EBD was performed were recorded for one year before and after epithelial cell sheet transplantation, and the intervals (in days) were evaluated. For about 6 months after transplantation, the intervals between EBDs were longer than in the year before transplantation. The patients were also aware of a reduction in dysphagia after transplantation. Conclusions These results suggest that cell sheet transplantation may be effective in preventing anastomotic stricture after surgery for congenital esophageal atresia, but the effect was temporary and limited in this case. Although we chose a very severe case for the first human clinical study, it may be possible to obtain a more definitive effect if the transplantation is performed before the disease becomes so severe. Future studies are needed to identify cases in which cell sheet transplantation is most effective and to determine the appropriate timeframes for transplantation. Trial registration: UMIN, UMIN000034566, registered 19 October 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000039393.

Published
2022

32. Risk of extracolonic malignancies and metachronous rectal cancer after colectomy and ileorectal anastomosis in familial adenomatous polyposis

Author

Hiroaki Nozawa, Kazuhito Sasaki, Hirofumi Sonoda, Kazushige Kawai, Hiroaki Ishii, Shigenobu Emoto, Koji Murono, Shinya Abe, Soichiro Ishihara, Junko Kishikawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, and Tetsuro Taira

Subjects
medicine.medical_specialty, RD1-811, Colorectal cancer, medicine.medical_treatment, Anastomosis, Familial adenomatous polyposis, Ileum, medicine, Humans, Gallbladder cancer, Metachronous rectal cancer, Thyroid cancer, Colectomy, Retrospective Studies, Rectal Neoplasms, business.industry, Anastomosis, Surgical, Rectum, Cancer, medicine.disease, Surgery, Treatment Outcome, Adenomatous Polyposis Coli, Extra-colonic malignancies, Duodenal cancer, business
Abstract

Background Analysis of long-term clinical outcomes of patients with familial adenomatous polyposis is critical in reducing or preventing the incidence of extracolonic malignancies after initial surgery. The aim of the present study was to clarify the long-term outcomes, and establish a surveillance strategy for surgically treated familial adenomatous polyposis patients. Methods Between January 1967 and March 2020, retrospective data were collected from 37 patients with familial adenomatous polyposis treated or monitored in our department. Occurrence of metachronous cancers, including rectal cancers and extracolonic malignancies, and other diseases was analyzed. Results The median follow-up duration after the first surgery was 13.8 years. Initially, 16 patients underwent total proctocolectomy with ileal pouch-anal anastomosis, 18 underwent total colectomy with ileorectal anastomosis, and three underwent other procedures. A secondary proctectomy was performed for 9 of the 18 patients who underwent ileorectal anastomosis. Rectal cancer was diagnosed in 6 patients who underwent ileorectal anastomosis. In addition, 5 gastric cancer, 2 duodenal cancer, 1 gallbladder cancer, and 1 thyroid cancer cases were diagnosed. The age at which the extracolonic malignancies were diagnosed was >50 years. 4 patients died due to metachronous rectal cancer, gastric cancer, or gallbladder cancer. Conclusion Careful consideration should be paid before choosing ileorectal anastomosis as the treatment procedure for familial adenomatous polyposis patients because completion proctectomy was eventually necessary for half of the patients. Long-term surveillance, with more frequent gastric surveillance for patients over 50 years, is important for the prevention and treatment of extracolonic malignancies in familial adenomatous polyposis patients.

Published
2022

33. Primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava

Author

Takashige Abe, Mikio Konno, Takahiro Osawa, Ryuji Matsumoto, Kiyohiko Hotta, Hiroshi Kikuchi, Nobuo Shinohara, and Ai Shimizu

Subjects
medicine.medical_specialty, kidney, business.industry, vena cava, Urology, Case Report, Case Reports, leiomyosarcoma, Inferior vena cava, Diseases of the genitourinary system. Urology, Tumor thrombus, medicine.vein, thrombus, medicine, cardiovascular system, Renal Leiomyosarcoma, Radiology, cardiovascular diseases, RC870-923, business
Abstract

Introduction We report a rare case of primary renal leiomyosarcoma with a tumor thrombus in the inferior vena cava. Case presentation A 54‐year‐old woman presented with right flank pain and abdominal distension. Physical examination findings were unremarkable. Abdominal computed tomography revealed a heterogeneously enhancing right solid renal mass with a thrombus in the renal vein extending into the inferior vena cava. Magnetic resonance imaging demonstrated a renal tumor with a thrombus about 4 cm below the hepatic vein. Chest computed tomography and bone scintigraphy were negative. The patient underwent right radical nephrectomy and vena cava thrombectomy. Histophathologic evaluation of the resected tumor confirmed the diagnosis of leiomyosarcoma. She underwent no adjuvant therapy. Seven months after surgery, the patient died following a 2‐month history of multiple pulmonary and hepatic metastases. Conclusion This report highlights the importance of considering the possibility of renal leiomyosarcoma invasion to the inferior vena cava, similar to renal cell carcinoma.

Published
2022

34. Effect of Robot-assisted Rehabilitation to Botulinum Toxin A Injection for Upper Limb Disability in Patients with Chronic Stroke: A Case Series and Systematic Review

Author

Hiroyuki Fukuda, Tooru Inoue, Takashi Morishita, Kazuya Saita, Hiroshi Abe, Toshiyasu Ogata, Koichi Hyakutake, and Satoshi Kamada

Subjects
single-joint hybrid assistive limb-assisted rehabilitation, Occupational therapy, medicine.medical_specialty, Combination therapy, medicine.medical_treatment, upper limb, Upper Extremity, Physical medicine and rehabilitation, occupational therapy, Paralysis, Humans, Medicine, Spasticity, Botulinum Toxins, Type A, Stroke, Rehabilitation, business.industry, Stroke Rehabilitation, Recovery of Function, Robotics, medicine.disease, stroke, Treatment Outcome, medicine.anatomical_structure, Upper limb, Original Article, Surgery, Neurology (clinical), botulinum toxin A therapy, medicine.symptom, business, Case series
Abstract

Combining single-joint hybrid assistive limb (HAL-SJ) with botulinum toxin A (BTX-A) therapy is novel and has great therapeutic potential for the rehabilitation of stroke patients with upper limb paralysis. The purpose of this observational case series study was to evaluate the effect of BTX-A and HAL-SJ combination therapy on different exoskeleton robots used for treating upper limb paralysis. The HAL-SJ combination received a BTX-A injection followed by HAL-SJ-assisted rehabilitation for 60 min per session, 10 times per week, during 2 weeks of hospitalization. Clinical evaluations to assess motor function, limb functions used during daily activities, and spasticity were performed prior to injection, at 2-week post-treatment intervention, and at the 4-month follow-up visit. The total Fugl-Meyer assessment-upper limb (FMA-UE), proximal FMA-UE, action research arm test (ARAT), Motor Activity Log (MAL), and Disability Assessment Scale (DAS) showed a statistically significant difference, and a large effect size. However, the FMA distal assessment at 2-week post-treatment intervention showed no significant difference and a moderate effect size. The FMA-UE scores of the extracted systematic review articles showed that our design improved upper limb function. The change in the total FMA-UE score in this study showed that, compared to previous reports in the exoskeletal robotic therapy group, our combination therapy had a higher score than five of the seven references. Our results suggest that BTX-A therapy and HAL-SJ combination therapy may improve upper limb function, similar to other treatment methods in the literature.

Published
2022

35. A Genome-Wide Association Study Predicts the Onset of Dysgeusia Due to Anti-cancer Drug Treatment

Author

Shiro Fujii, Kumiko Kagawa, Masahiro Abe, Naoto Okada, Hirokazu Miki, Shingen Nakamura, Youichi Sato, Keisuke Ishizawa, and Minori Takei

Subjects
Oncology, medicine.medical_specialty, Side effect, Pharmaceutical Science, Antineoplastic Agents, Single-nucleotide polymorphism, Genome-wide association study, Dysgeusia, Polymorphism, Single Nucleotide, symbols.namesake, Quality of life, single nucleotide polymorphism, Internal medicine, medicine, Humans, SNP, Genetic Predisposition to Disease, Pharmacology, Sanger sequencing, Hematology, business.industry, General Medicine, Pharmaceutical Preparations, anti-cancer drug, Quality of Life, symbols, medicine.symptom, business, hematopoietic tumor, Genome-Wide Association Study
Abstract

Dysgeusia is a major side effect of anti-cancer drug treatment. Since dysgeusia significantly lowers the patient’s QOL, predicting and avoiding its onset in advance is desirable. Accordingly, aims of the present study were to use a genome-wide association study (GWAS) to identify genes associated with the development of dysgeusia in patients taking anti-cancer drugs and to predict the development of dysgeusia using associated single nucleotide polymorphisms (SNPs). GWAS was conducted on 76 patients admitted to the Department of Hematology, Tokushima University Hospital. Using Sanger sequencing for 23 separately collected validation samples, the top two SNPs associated with the development of dysgeusia were determined. GWAS identified rs73049478 and rs41396146 SNPs on the retinoic acid receptor beta (RARB) gene associated with dysgeusia development due to the administration of anti-cancer drugs. Evaluation of the two SNPs using 23 validation samples indicated that the accuracy rate of rs73049478 was relatively high (87.0%). Thus, the findings of the present study suggest that the rs73049478 SNP of RARB can be used to predict the onset of dysgeusia caused by the administration of anti-cancer drugs.

Published
2022

36. Clinical usefulness of left ventricular outflow tract velocity time integral for heart failure with reduced ejection fraction with rapid atrial fibrillation during landiolol treatment

Author

Kozo Okada, Yugo Minamimoto, Kiyoshi Hibi, Hironori Takahashi, Takeru Abe, Kouichi Tamura, Noriaki Iwahashi, Yuichiro Kimura, Yohei Hanajima, Kazuo Kimura, Toshiaki Ebina, Masami Kosuge, Mutsuo Horii, Jin Kirigaya, and Yasushi Matsuzawa

Subjects
medicine.medical_specialty, Acute decompensated heart failure, Morpholines, Ventricular Function, Left, Internal medicine, Atrial Fibrillation, Heart rate, medicine, Humans, Urea, Ventricular outflow tract, Hospital Mortality, Prospective Studies, Heart Failure, Ejection fraction, business.industry, Stroke Volume, Atrial fibrillation, Landiolol, Prognosis, medicine.disease, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business, Mace, medicine.drug
Abstract

Background Landiolol enables us to treat the patients with rapid atrial fibrillation (AF) with acute decompensated heart failure (ADHF) efficiently. We sought to determine the role of echocardiography in predicting the prognosis. Methods Among 314 patients, a total 115 ADHF patients with reduced ejection fraction and rapid AF were enrolled. They received landiolol treatment to decrease the heart rate (HR) to 20% within 24 h. The dose of landiolol was increased every 2 h; then, we performed echocardiography repeatedly, at baseline, 2 h, and 24h. We followed the patients after discharge for 180 days, and checked cardiac death and HF hospitalization as major adverse cardiac events (MACE). Results During initial hospitalization, 5 patients (4%) died. During 180 days after discharge, 19 (16%) out of 115 patients experienced MACE (2 cardiac death, 17 HF rehospitalization, 5 in-hospital death). Multivariate analysis showed that the change in left ventricular outflow tract-velocity time integral (LVOT-VTI) at 2 h was the most significant predictor for MACE (hazard ratio =1.21, 95% confidence interval: 1.10-1.83, p=0.0001). Kaplan-Meier curves demonstrated the patients with deteriorated LVOT-VTI at minimum dose landiolol suggested the high-risk patients for MACE (χ2=30.9, p Conclusions During landiolol treatment, the patients with deteriorated LVOT-VTI predicted the poor prognosis. We may detect the high-risk patients by two-point echocardiography. UMIN000020084. Registered 1 November 2013 – prospective study https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&language=J&recptno=R000023203

Published
2022

37. Immunohistochemical Detection of Bacteria in the Resected Valves was Associated with Stromal Immune Checkpoint Protein Expression that may Contribute to Calcific Aortic Stenosis

Author

Ken Shirabe, Tomonobu Abe, Hiroshi Saeki, Wataru Tatsuishi, Bilguun Erkhem-Ochir, Takehiko Yokobori, and Navchaa Gombodorj

Subjects
Lipopolysaccharides, Pulmonary and Respiratory Medicine, Aortic valve, Pathology, medicine.medical_specialty, Lipopolysaccharide, Regulatory T cell, B7-H1 Antigen, chemistry.chemical_compound, Immune system, medicine, Humans, Bacteria, business.industry, FOXP3, Forkhead Transcription Factors, Aortic Valve Stenosis, General Medicine, Immune Checkpoint Proteins, medicine.disease, Immune checkpoint, Treatment Outcome, medicine.anatomical_structure, chemistry, Aortic Valve, Surgery, Lipoteichoic acid, Cardiology and Cardiovascular Medicine, business, Calcification
Abstract

Aortic stenosis (AS) is a disease characterized by narrowing of the aortic valve (AV) orifice. The purpose of this study was to clarify the significance of bacterial detection and clinicopathological factors, including valve-infiltrating immune cells and disease severity, in relation to AS. After obtaining the written informed consent form from 50 patients with AS, we performed immunohistochemical analysis of lipopolysaccharide (LPS) for gram-negative bacteria and lipoteichoic acid (LTA) for gram-positive bacteria on surgically resected-AVs. Moreover, we evaluated the relationships among the presence of bacteria, immune checkpoint protein PD-L1 expression, and immune cell infiltrations such as CD8-positive T lymphocytes, CD163-positive macrophages, and FOXP3-positive regulatory T cell (Treg) in resected-aortic valves. LPS detection in the resected-aortic valve tissues was significantly associated with stromal PD-L1 expression, valve calcification, and LTA existence in resected samples. We showed that the presence of LPS was significantly related to high PD-L1 expression only in calcified-AVs, not in non-calcified-AVs. Moreover, the high expression of PD-L1 in AS samples without LPS was significantly associated with positive infiltration of CD163-positive macrophages and FOXP3-positive Tregs. Immunohistochemical bacterial detection in resected-aortic valves was associated with PD-L1 accumulation and valve calcification. PD-L1 significantly accumulated only in calcified valves with LPS existence.

Published
2022

38. Invasive pulmonary aspergillosis after liver transplantation: lessons from successfully treated cases and review of the literature

Author

Yasushi Hasegawa, Minoru Kitago, Yuko Kitagawa, Yuta Abe, Tomoyuki Hishida, Hideaki Obara, Shunsuke Uno, Hiroshi Yagi, Masahiro Shinoda, and Kodai Abe

Subjects
Voriconazole, medicine.medical_specialty, business.industry, Incidence (epidemiology), medicine.medical_treatment, Medical record, General Medicine, Liver transplantation, Invasive pulmonary aspergillosis, bacterial infections and mycoses, Single Center, respiratory tract diseases, Surgery, 03 medical and health sciences, 0302 clinical medicine, Surgical oncology, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, Lung resection, skin and connective tissue diseases, business, medicine.drug
Abstract

Invasive pulmonary aspergillosis (IPA) after liver transplantation (LT) is most often fatal. We analyzed the outcomes of IPA in a single center. We reviewed, retrospectively, the medical records of recipients of living donor LT (LDLT) or deceased donor LT (DDLT) performed between 1995 and 2019 at our institute. We analyzed the incidence of IPA and assessed the treatment courses of patients treated successfully and those not treatment successfully. Among 326 recipients, IPA was diagnosed in 6 (1.8%). The incidence of IPA was significantly higher in patients with acute liver failure (ALF, 9.8%) than in those without ALF (0.4%), after DDLT (8.8%) than after LDLT (1.0%), and in recipients who received preoperative steroid pulse therapy (16.0%) than in those who did not (0.7%). Complete cure of IPA was achieved in the most recent three patients, by administering voriconazole immediately after the diagnosis of IPA and performing lung resection, while the IPA lesion was single and localized. Patients with risk factors for IPA must be monitored closely. Our three successfully treated cases demonstrate that initiating immediate voriconazole treatment and making a calculated decision about lung resection can contribute to a favorable outcome.

Published
2021

39. Hypertensive Cardiomyopathy with Congestive Heart Failure in an Infant with Unilateral Wilms Tumor: A Case Report

Author

Yousuke Abe, Sayuri Matsui, Mitsunori Sato, Jun Kuwabara, Satoshi Kikuchi, Shigehiro Koga, Takayasu Kawamoto, Yusuke Matsuno, Kei Ishimaru, Yuji Watanabe, Hiroyuki Egi, Motohira Yoshida, Kazufumi Tanigawa, Katsuya Watanabe, and Satoshi Akita

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Cardiomyopathy, Wilms Tumor, Plasma renin activity, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Renin, medicine, Humans, Child, Heart Failure, business.industry, Infant, Wilms' tumor, General Medicine, Abdominal distension, medicine.disease, Kidney Neoplasms, Abdominal mass, Nephrectomy, Blood pressure, 030220 oncology & carcinogenesis, Heart failure, Hypertension, Cardiology, 030211 gastroenterology & hepatology, medicine.symptom, Cardiomyopathies, business
Abstract

Wilms tumor (WT) is the most common malignant kidney tumor in children. High blood pressure is seen in up to 55% of children with WT. However, hypertensive cardiomyopathy with congestive heart failure due to WT is remarkably rare, with only several cases reported worldwide. In this report, a pediatric case of WT with hypertension causing hypertensive cardiomyopathy and congestive heart failure is presented. An 8-month-old male child with abdominal distension was seen by his primary physician. He was referred to our hospital for further examination and treatment. Abdominal contrast-enhanced computed tomography demonstrated a weakly enhancing, large abdominal mass, which was larger than 12 cm. Two-dimensional transthoracic echocardiography showed a diffuse hypokinetic left ventricle. The patient was diagnosed with cardiomyopathy caused by hypertension. Open surgical resection of the mass was successfully performed. His postoperative course was uncomplicated, and the patient was successfully discharged. The plasma renin activity was maintained at a high level even after left nephrectomy, suggesting that the right kidney was likely the source of renin secretion. Mechanical compression of the right renal blood vessels by a greatly enlarged left kidney can cause right renal ischemia, which activates renin excretion. Nephrectomy can be an effective treatment for a WT patient with hypertension causing hypertensive cardiomyopathy, and then cardiac function will be improved within several weeks. We recommend routine echocardiography surveillance in patients with WT. This report can help pediatric surgeons become more familiar with cardiomyopathy caused by WT.

Published
2021

40. Subcutaneous adipose tissue distribution and serum lipid/lipoprotein in unmedicated postmenopausal women: A B-mode ultrasound study

Author

Jeremy P. Loenneke, Scott J. Dankel, Vickie Wong, Zachary W. Bell, Robert W. Spitz, and Takashi Abe

Subjects
medicine.medical_specialty, Postmenopausal women, Radiological and Ultrasound Technology, business.industry, B mode ultrasound, Medicine (miscellaneous), Endocrinology, Internal medicine, Distribution (pharmacology), Medicine, Radiology, Nuclear Medicine and imaging, Subcutaneous adipose tissue, business, Lipoprotein
Abstract

Background It has been observed that gluteal-femoral adipose tissue has a protective effect against risk factors for cardiovascular disease but has not yet been concluded how different evaluation methods of fat distribution affect the results. Methods To test the hypothesis that B-mode ultrasound-measured subcutaneous adipose tissue distribution is associated with cardiovascular risk factors, 326 Japanese unmedicated postmenopausal women aged 50–70 years were analyzed. Subcutaneous adipose tissue thickness at 6 sites (anterior and posterior aspects of trunk, upper-arm, and thigh) and serum total (TC) and high-density lipoprotein cholesterol (HDLC) was measured, and a ratio of HDLC to TC (HDLC/TC) was calculated. We used Bayesian linear regression with 4 separate models with each model predicting HDLC/TC. Results Our first model provided evidence for an inverse correlation (r = –0.23) between ultrasound measured body fat (6 site measurement) and HDLC/TC. The second model noted evidence for an inverse correlation between trunk fat and HDLC/TC and found evidence for the null with respect to the correlation between thigh fat and HDLC/TC. Therefore, we added thigh fat to the null model to produce Distribution Model 2. Within this model, we noted an inverse correlation (r = –0.353) between trunk fat and HDLC/TC. Our last model determined that within the trunk fatness, the abdominal area (anterior trunk) was a larger predictor than the subscapular site (posterior trunk). Conclusion These results support the evidence that ultrasound-measured abdominal subcutaneous adipose tissue thickness is a non-invasive predictor for monitoring the risk for dyslipidemia in postmenopausal women.

Published
2021

41. Clinical usefulness of red dichromatic imaging in hemostatic treatment during endoscopic submucosal dissection: First report from a multicenter, open‐label, randomized controlled trial

Author

Seiichiro Abe, Yosuke Tsuji, Daisuke Ohki, Yutaka Saito, Motohiko Kato, Ai Fujimoto, Naohisa Yahagi, Shiko Kuribayashi, Tadateru Maehata, Toshio Uraoka, Kosuke Nomura, Hiroshi Yasuda, Yasumasa Matsuo, and Syu Hoteya

Subjects
Hemostasis, medicine.medical_specialty, Endoscopic Mucosal Resection, business.industry, Stomach, Perforation (oil well), Gastroenterology, Endoscopic submucosal dissection, Hemostatics, Surgery, law.invention, Treatment Outcome, medicine.anatomical_structure, Randomized controlled trial, law, Clinical endpoint, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Esophagus, Open label, business
Abstract

OBJECTIVES To verify the efficacy and safety of Red Dichromatic Imaging (RDI) in hemostatic procedures during endoscopic submucosal dissection (ESD). METHODS This is a multicenter randomized controlled trial of 404 patients who underwent ESD of the esophagus, stomach, colorectum. Patients who received hemostatic treatments by RDI during ESD were defined as the RDI group (n=204), and those who received hemostatic treatments by white light imaging (WLI) were defined as the WLI group (n=200). The primary endpoint was a shortening of the hemostasis time. The secondary endpoints were a reduction of the psychological stress experienced by the endoscopist during the hemostatic treatment, a shortened treatment time, and a non-inferior perforation rate, in RDI versus WLI. RESULTS The mean hemostasis time in RDI (n=860) was not significantly shorter than that in WLI (n=1049) (62.3±108.1 versus 56.2±74.6 seconds; p=0.921). The median hemostasis time was significantly longer in RDI than in WLI (36.0 (18.0-71.0) versus 28.0 (14.0-66.0) seconds; p=0.001) in a sensitivity analysis. The psychological stress was significantly lower in RDI than in WLI (1.71±0.935 versus 2.03±1.038; p

Published
2021

42. Low serum pancreatic amylase levels as a novel latent risk factor for colorectal adenoma in non‐alcohol drinkers

Author

Yoshiyuki Ueno, Yasuhiko Abe, Takayuki Sakai, Naoko Mizumoto, Minami Ito, Matsuki Umehara, Takashi Kon, Makoto Yagi, Yusuke Onozato, Yu Sasaki, and Shoichi Nishise

Subjects
Adenoma, medicine.medical_specialty, Pancreatic disease, genetic structures, Hepatology, Colorectal cancer, business.industry, Gastroenterology, Colorectal adenoma, medicine.disease, Obesity, Cross-Sectional Studies, Insulin resistance, Non-alcoholic Fatty Liver Disease, Risk Factors, Internal medicine, Amylases, Nonalcoholic fatty liver disease, medicine, Humans, Risk factor, Colorectal Neoplasms, business
Abstract

Obesity, insulin resistance, and metabolic alterations increase the risk of colorectal cancer and adenoma (CRA). Non-alcoholic fatty liver disease (NAFLD) or pancreatic disease (NAFPD) shares many risk factors with CRA that may have significant roles in its development; however, the relationship between CRA and NAFLD/NAFPD remains unclear.This cross-sectional study recruited 712 eligible participants without current drinking who had undergone total colonoscopy as part of a health checkup. These participants were classified into a CRA group (n = 236) and a control group (n = 439), which consisted of individuals without CRA and a history of polyp resection. NAFLD and NAFPD were diagnosed based on abdominal ultrasonography findings.Non-alcoholic fatty liver disease was observed more frequently in individuals with CRA than in the control group (55.9% vs 41.6%, P 0.01). There was no significant association between NAFPD and CRA; however, serum pancreatic amylase (P-amylase) levels were significantly lower in individuals with CRA. Although NAFLD was one of the factors increasing the presence of CRA (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.07-2.10), low P-amylase levels were significantly associated with the presence of CRA (OR, 1.73; 95% CI, 1.04-2.88) independent of age, sex, current smoking, obesity, metabolic alterations including insulin resistance, and NAFLD.Low serum P-amylase levels were a possible independent risk factor for CRA in the present study. The latent pancreatic exocrine-endocrine-gut relationship was considered a novel pathway involved in obesity-related CRA development, in non-alcoholic individuals.

Published
2021

43. Analysis of bone in adenine-induced chronic kidney disease model rats

Author

Hikaru Saito, Yoichi Shimada, Koji Nozaka, Hiroyuki Tsuchie, Ryo Shoji, Kazunobu Abe, Naohisa Miyakoshi, Yuji Kasukawa, and Chiaki Sato

Subjects
medicine.medical_specialty, Osteoporosis, Urology, chemistry.chemical_element, Bone strength, Diseases of the musculoskeletal system, Calcium, urologic and male genital diseases, chemistry.chemical_compound, Chronic kidney disease, medicine, Bone mineral density, Femur, Bone mineral, Creatinine, business.industry, medicine.disease, medicine.anatomical_structure, chemistry, Bone microstructure, RC925-935, Secondary hyperparathyroidism, Cortical bone, Original Article, business, Kidney disease
Abstract

Objectives The purpose of this study is to investigate the stage of chronic kidney disease (CKD) in adenine-induced CKD model rats by serum analyses, and to examine bone mineral density (BMD), bone strength, and microstructure of trabecular and cortical bone in these rats. Methods Eight-week-old, male Wistar rats (n = 42) were divided into 2 groups: those fed a 0.75% adenine diet for 4 weeks until 12 weeks of age to generate CKD model rats (CKD group); and sham rats. The CKD and sham groups were sacrificed at 12, 16, and 20 weeks of age (n = 7 in each group and at 12, 16, and 20 weeks), and various parameters were evaluated, including body weight, renal wet weight, muscle wet weight, renal histology, biochemical tests, BMD, biomechanical testing, and micro-computed tomography (CT). The parameters were compared between the 2 groups at the various time points. Results In the CKD model rats, at 20 weeks of age, serum creatinine, phosphorus, and intact-PTH levels were elevated, and serum calcium levels were normal, indicating that the CKD was stage IV and associated with secondary hyperparathyroidism. Decreased BMDs of the whole body and the femur were observed as bone changes, and micro-CT analysis showed deterioration of bone microstructure of the cortical bone that resulted in decreased bone strength in the cortical and trabecular bone. Conclusions These CKD model rats showed stage IV CKD and appear appropriate for evaluating the effects of several treatments for CKD-related osteoporosis and mineral bone disorder.

Published
2021

44. Collagen Vitrigel Membrane-Coated Nylon Line Prevents Stenosis After Conization of the Cervix Uteri

Author

Takashi Akutagawa, Shuji Toda, Yasuhisa Sakata, Fumikazu Matsuhisa, Mizuki Tayama-Abe, Maki Futamata, Kei Nagase, Mariko Hashiguchi, Toshiaki Takezawa, Shigehisa Aoki, Masatoshi Yokoyama, Shuji Kitajima, Kotaro Yamaji, and Sayuri Morito

Subjects
medicine.medical_specialty, 0206 medical engineering, Conization, Biomedical Engineering, Bioengineering, Cervix Uteri, Constriction, Pathologic, 02 engineering and technology, Malignancy, Biochemistry, Biomaterials, 03 medical and health sciences, Fibrosis, medicine, Animals, Humans, Cervix, 030304 developmental biology, Cervical cancer, 0303 health sciences, business.industry, Postoperative complication, medicine.disease, 020601 biomedical engineering, Surgery, Nylons, Stenosis, medicine.anatomical_structure, Female, Collagen, Rabbits, Complication, business, Myofibroblast
Abstract

Cervical stenosis is a postoperative complication of conization for uterine cervical malignancy, but a standard method of preventing this complication has yet to be established. Collagen vitrigel is a collagen-based biomaterial that has antifibrotic and epithelization promoting actions. We evaluated the antistenotic effect of an indwelling collagen vitrigel membrane-coated nylon line (CVNL) after cervical conization in rabbits. In one group of rabbits, a CVNL was placed in the cervical canal after conization. In another group, a nylon line without a collagen coating was placed in the cervical canal after conization. The control group underwent cervical conization without placement of a device. The control (conization alone) and nylon (conization plus indwelling nylon line) groups exhibited cervical swelling. Rabbits in the CVNL group (cervical conization plus indwelling CVNL in the xerogel state) had a normal cervical surface. The cervical canal in the control group was enlarged and showed cystic changes attributed to cervical stenosis. The nylon group exhibited a trend toward cervical canal dilatation. In the CVNL group, the cervical canal was normal and did not show cystic dilatation. Fibrosis occurred to a lesser degree in the nylon group than in the control group, and the CVNL group exhibited minimal interstitial fibrosis. The control and nylon groups showed increased numbers of myofibroblasts in the regenerated cervix, but few myofibroblasts were observed in the CVNL group. Abundant collagen type III was observed in regenerated cervical tissue in the control and nylon groups but not in the CVNL group. The number of proliferative mesenchymal cells in the regenerated cervix was lowest in the CVNL group. The expressions of connective tissue growth factor (CTGF, a regulator of fibroblast growth and extracellular matrix secretion), extracellular signal-regulated protein kinases 1 and 2, and c-Jun N-terminal kinase (which are involved in the induction of CTGF by transforming growth factor-β) were lower in the CVNL group than in the control or nylon groups. This study describes an indwelling CVNL that prevents cervical stenosis and cystic changes after conization. These effects were likely mediated by inhibition of fibrosis, myofibroblast emergence, CTGF expression, and collagen type III deposition in regenerating cervix. Impact statement Collagen vitrigel is a high-density collagen material that promotes epithelization, inhibits fibrosis, and suppresses inflammation in regenerating tissue. We evaluated whether a collagen vitrigel membrane-coated nylon line would prevent cervical stenosis after conization in the rabbit. We found that an indwelling collagen vitrigel membrane-coated nylon line prevented cervical canal stenosis and cystic changes after cervical conization by inhibiting fibrosis, myofibroblast emergence, connective tissue growth factor expression, and collagen type III deposition in the regenerating cervix. Our device has potential as a new method of preventing cervical canal fibrosis and stenosis after conization for cervical cancer.

Published
2021

45. Suppression of acute heart failure rehospitalization by biventricular pacing in wide QRS and mid‐range ejection fraction

Author

Naohiko Takahashi, Hidekazu Kondo, Ichitaro Abe, Nozomi Kodama, Tomoko Fukuda, Koshiro Akamine, Kei Hirota, Kunio Yufu, Keisuke Yonezu, and Katsunori Tawara

Subjects
medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Case Report, HFmrEF, Afterload, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, cardiovascular diseases, Pulmonary wedge pressure, Cardiac catheterization, Mitral regurgitation, Ejection fraction, business.industry, Acute heart failure, medicine.disease, Dyssynchrony, Blood pressure, Heart failure, RC666-701, Cardiology, cardiovascular system, Cardiology and Cardiovascular Medicine, business
Abstract

We present a 66‐year‐old male patient with heart failure, mid‐range ejection fraction and QRS widening suffering from recurrent hospitalization due to acute heart failure. We measured intra‐cardiac pressure by cardiac catheterization to clearly demonstrate the augmentation of afterload by a vasoconstricting drug induced increase of left ventricular end‐diastolic blood pressure and pulmonary capillary wedge pressure with pulmonary arterial V‐wave augmentation (indicator of worsening of mitral regurgitation). Because the patient was considered as refractory to optimal medication, cardiac resynchronization therapy (CRT) was performed. After CRT implantation, these factors were improved, and the patient has not experienced recurrent hospitalization for >2 years.

Published
2021

46. A case of pulmonary pleomorphic carcinoma with preexisting interstitial pneumonia successfully treated with pembrolizumab

Author

Kensuke Kondo, Yohei Yabuki, Hiroshi Nokihara, Atsushi Mitsuhashi, Hiroto Yoneda, Akane Abe, Masahiro Sako, Yasuhiko Nishioka, Kenji Otsuka, Ryohiko Ozaki, Hirokazu Ogino, and Hisanori Uehara

Subjects
Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, pulmonary pleomorphic carcinoma, medicine.medical_treatment, Case Report, Pembrolizumab, Case Reports, Pleomorphic carcinoma, Refractory, Internal medicine, medicine, Interstitial pneumonia, Adverse effect, Lung cancer, RC254-282, Pneumonitis, interstitial pneumonia, Chemotherapy, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, General Medicine, medicine.disease, pembrolizumab, business
Abstract

Pulmonary pleomorphic carcinoma is often refractory to chemotherapy and follows an aggressive clinical course. Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced lung cancer, and a few cases with pleomorphic carcinoma have been reported to show tumor shrinkage after therapy with ICIs. When treating patients with ICIs, patient selection is essential, and monitoring and management of immune‐related adverse events, including pneumonitis, are needed. We herein report a case of pulmonary pleomorphic carcinoma with preexisting interstitial pneumonia treated with pembrolizumab, antiprogrammed cell death 1 antibody. Our report highlights important considerations necessary when treating advanced pleomorphic carcinoma patients complicated with interstitial pneumonia. We also review the literature regarding the use of ICIs in such patients.

Published
2021

47. Identification of children with first afebrile seizure for whom neuroimaging is unnecessary

Author

Satoshi Tsuji, Akira Nagai, Mitsuru Kubota, Shunsuke Amagasa, Yuich Abe, and Satoko Uematsu

Subjects
Pediatrics, medicine.medical_specialty, Univariate analysis, business.industry, Infant, Neuroimaging, General Medicine, Neurological disorder, Emergency department, medicine.disease, Disease cluster, Magnetic Resonance Imaging, Epilepsy, Neurology, Pediatric emergency medicine, Seizures, medicine, Humans, Neurology (clinical), Abnormality, Child, Tomography, X-Ray Computed, business, Retrospective Studies
Abstract

Purpose To find ways to identify children with first afebrile seizure for whom neuroimaging is unnecessary. Methods We retrospectively reviewed the clinical records of children younger than 19 years of age with the first afebrile seizure who visited the emergency department of the National Center for Child Health and Development in Japan between May 2014 and December 2020. We investigated the relationship between age, sex, focal seizure, seizure duration, seizure cluster, neurological findings, and CT and/or MRI abnormalities by univariate analysis. Furthermore, to identify children with low probability of intracranial abnormality, we performed decision tree analysis by classification and regression tree methods. Results Among the eligible 611 children, 14 children had a CT abnormality (4.2% of patients who underwent CT) and 26 had a CT or MRI abnormality (7.1% of patients who underwent CT or MRI). Six children had an urgent neuroimaging abnormality. In the univariate analysis, seizure cluster (P = 0.02) was significantly associated with CT abnormality, and focal seizure (P = 0.01) and seizure prolonged for more than 5 min (P = 0.04) were significantly associated with CT or MRI abnormality. The decision tree analysis identified seizure cluster, prolonged seizure, neurological disorder, and focal seizure as risk factors for CT abnormalities in that order. Conclusion Children without seizure cluster, seizure prolonged for more than 5 min, and neurological disorder may not require CT in the emergency room. The clinician could determine the necessity of neuroimaging by seizure cluster, prolonged seizure, focal seizure, and neurological disorder.

Published
2021

48. Positive Lusitropic Effect of Quercetin on Isolated Ventricular Myocardia from Normal and Streptozotocin-Induced Diabetic Mice

Author

Jun Kainuma, Shogo Hamaguchi, Iyuki Namekata, Momoka Komatsu, Hikaru Tanaka, and Kohei Abe

Subjects
Male, medicine.medical_specialty, Indoles, Lusitropy, Heart Ventricles, Pharmaceutical Science, Endoplasmic Reticulum, Diabetes Mellitus, Experimental, Mice, Ventricular Dysfunction, Left, chemistry.chemical_compound, Reference Values, Internal medicine, Ventricular Pressure, medicine, Animals, heterocyclic compounds, Enzyme Inhibitors, Adenosine Triphosphatases, Pharmacology, Aniline Compounds, Myocardial tissue, Relaxation (psychology), Plant Extracts, Chemistry, Myocardium, Phenyl Ethers, Diabetic mouse, General Medicine, Streptozotocin, Myocardial Contraction, Endocrinology, cardiovascular system, Calcium, Quercetin, Plants, Edible, Cyclopiazonic acid, Reticulum, medicine.drug
Abstract

The lusitropic effect of quercetin was examined on isolated ventricular myocardial tissue preparations from normal and streptozotocin-induced diabetic mice. The time required for 90% relaxation of the myocardium, which was prolonged in the diabetic mice, was shortened by quercetin in both normal and diabetic myocardia. This effect of quercetin was completely inhibited by cyclopiazonic acid but not by SEA0400. These results indicated that quercetin accelerates myocardial relaxation through activation of the sarco-endoplasmic reticulum Ca2+-ATPase.

Published
2021

49. One-Stage Perifascial Areolar Tissue and Skin Grafting Combined with Negative Pressure Wound Therapy for a Refractory Wound with an Exposed Elbow Joint and Extensive Skin Defect

Author

Shinji Nagasaka, Yoshiro Abe, Soushi Ishida, Hiroyuki Yamasaki, Yutaro Yamashita, Kazuhide Mineda, and Ichiro Hashimoto

Subjects
medicine.medical_specialty, Articular capsule of the knee joint, business.industry, medicine.medical_treatment, Elbow, Granulation tissue, Soft tissue, Surgery, Plastic surgery, medicine.anatomical_structure, Negative-pressure wound therapy, medicine, Skin grafting, business, Wound healing
Abstract

Joint exposure with an extensive skin defect following soft tissue tumor resection might cause a refractory ulcer. Although a vascularized tissue transplant is ideal for ulcer treatment, it is a highly invasive procedure and usually unsuitable for older patients with general prostration. One-stage perifascial areolar tissue (PAT) and skin grafting combined with negative pressure wound therapy (NPWT) is less invasive and effective procedure for refractory wounds with exposed bones and tendons. This is the first case where this procedure was used to treat a wound that involved an exposed elbow joint with an extensive skin defect. An 80-year-old woman underwent wide excision to remove a leiomyosarcoma on the olecranon with reconstruction using an ipsilateral pedicled latissimus dorsi musculocutaneous flap. The distal three-quarter of the flap was necrosed owing to insufficient blood supply. Furthermore, an articular capsule deficit of 1.5 × 1.0 cm2 was found during necrotomy. The PAT was harvested from the lower abdomen as a non-vascularized tissue, and the articular capsule deficit was covered by overlapping on the granulation tissue around the deficit. Simultaneous split-thickness skin grafting combined with NPWT was applied on the PAT and residual skin defect. Wound healing was achieved in 4 weeks postoperatively without synovial fluid leakage. Elbow joint motion ranging from 0 to 120° was maintained 18 months postoperatively. This procedure helped achieve better wound healing and sufficient functional outcome. Furthermore, this can help decrease patients’ burden by preventing invasive resections associated with severe functional impairments or long-term rehabilitation requirements.

Published
2021

50. Alcohol intake and stomach cancer risk in Japan: A pooled analysis of six cohort studies

Author

Kenji Wakai, Tetsuya Mizoue, Shiori Tanaka, Tetsuhisa Kitamura, Kotaro Ozasa, Shuhei Nomura, Keitaro Matsuo, Shizuka Sasazuki, Michihiro Muto, Hidekazu Suzuki, Taichi Shimazu, Tomio Nakayama, Yingsong Lin, Norie Sawada, Motoki Iwasaki, Tetsuya Otani, Keitaro Tanaka, Isao Oze, Atsuko Sadakane, Shoichiro Tsugane, Sarah Krull Abe, Mariko Naito, Eiko Saito, Yoshikazu Nishino, Yoshitaka Tsubono, Chisato Nagata, Yumi Sugawara, Keiko Wada, Ayami Ono, Taiki Yamaji, Takashi Tamura, Ichiro Tsuji, Hidemi Ito, Yuri Kitamura, Hadrien Charvat, Akiko Tamakoshi, Mai Utada, and Mamami Inoue

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Alcohol Drinking, Gastroenterology, Cohort Studies, Japan, Stomach Neoplasms, Internal medicine, cohort study, Humans, Medicine, Stomach cancer, Aged, Aged, 80 and over, Sex Characteristics, stomach cancer, business.industry, Proportional hazards model, Incidence, Incidence (epidemiology), Hazard ratio, Epidemiology and Prevention, Cancer, Original Articles, General Medicine, Middle Aged, medicine.disease, Confidence interval, Pooled analysis, Oncology, Regression Analysis, Female, Original Article, pooled analysis, business, alcohol intake, Cohort study
Abstract

The association between alcohol intake and stomach cancer risk remains controversial. We undertook a pooled analysis of data from six large‐scale Japanese cohort studies with 256 478 participants on this topic. Alcohol intake as ethanol was estimated using a validated questionnaire. The participants were followed for incidence of stomach cancer. We calculated study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) for stomach cancer according to alcohol intake using a Cox regression model. Summary HRs were estimated by pooling the study‐specific HRs using a random‐effects model. During 4 265 551 person‐years of follow‐up, 8586 stomach cancer cases were identified. In men, the multivariate‐adjusted HRs (95% CIs) of stomach cancer were 1.00 (0.87‐1.15) for occasional drinkers, and 1.00 (0.91‐1.11) for, Alcohol intake increased stomach cancer risk in men, and heavy drinkers showed a greater point estimate of risk for proximal cancer than for distal cancer.

Published
2021

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