Biomarker-based pre-heart failure screening in a middle-aged rural population.

Background: Guidelines recommend biomarker-based screening for pre-heart failure (pre-HF) among at-risk populations. Although the asymptomatic nature of pre-HF necessitates proactive screening, real-world implementation remains understudied. This retrospective study analyzed data from a regional pre-HF screening initiative, integrated into annual health screenings, to evaluate: (1) the prevalence of elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, (2) associated echocardiographic findings, and (3) adherence across the screening-to-consultation pathway.

From Wound Coverage to Functional Healing: A Narrative Review of Biomaterial Applications in Head and Neck Mucosal Defects.

Background: Reconstruction of head and neck mucosal defects presents unique challenges due to the anatomical complexity and functional demands of the region. Artificial biomaterials such as collagen and polyglycolic acid (PGA) sheets have gained clinical traction owing to their ease of use and reduced surgical burden. However, limitations such as local inflammation, degradation-related complications, and mechanical instability-particularly in highly mobile areas like the tongue-continue to hinder their broader application.

Identifying novel risk factors for ocular lesions in patients with fungemia and determining the efficacy of routine screening.

Purpose: To identify novel risk factors associated with the presence of fungal ocular lesions in patients with fungemia and to evaluate the validity and efficacy of routine screening.

Study Design: Retrospective study METHODS: The medical records of 198 patients diagnosed with fungemia by blood culture at 3 medical centers in Japan between March 2017 and April 2022 were analyzed. Ocular lesions were categorized as possible, probable, or proven, according to previously established definitions.

Heterogeneous Cardiovascular Effects of SGLT2 Inhibitors in Type 2 Diabetes: A Causal Forest and Target Trial Emulation Study.

Aims: Evidence is limited as to who benefit the most from sodium-glucose cotransporter-2 inhibitors (SGLT2i), especially among people without elevated cardiovascular disease (CVD) risk. To address this knowledge gap, we investigated the heterogeneity in the effect of SGLT2i across CVD risk profiles.

Methods: Using a target trial emulation framework, we compared SGLT2i versus dipeptidyl peptidase 4 inhibitors (DPP4i) in a nationwide insurer-based database of working-age Japanese citizens in 2015-2023.

Comparison of prednisolone monotherapy vs. tacrolimus combination in NMOSD: Efficacy, safety, and optimal therapeutic timing.

Tacrolimus (TAC) has been considered an effective treatment for neuromyelitis optica spectrum disorder (NMOSD), a neuroinflammatory disease associated with aquaporin-4 antibodies. This retrospective cohort study aimed to assess the efficacy and safety of TAC-based therapies compared with prednisolone (PSL) monotherapy in preventing relapse and optimizing treatment timing. Forty-one patients with NMOSD treated at Hiroshima University Hospital between 2015 and 2022 were included in the analysis.

Impact of the preoperative modified 5-item frailty index on the efficacy of neoadjuvant chemotherapy in patients with muscle invasive bladder cancer.

Purpose: We aimed to determine the optimal treatment strategy for MIBC patients undergoing neoadjuvant chemotherapy (NAC) followed by radical cystectomy. We investigated whether preoperative frailty influences the efficacy of NAC by evaluating the Modified 5-item Frailty Index (mFI-5), which was developed as a comprehensive geriatric evaluation tool with a reduced number of variables to simplify data collection.

Methods: This retrospective study included 356 MIBC patients.

Personalised & optimised therapy (POT) algorithm using five cognitive and behavioural skills for subthreshold depression.

Personalising psychotherapies for depression may enhance their efficacy. We conducted a randomised controlled trial of smartphone cognitive-behavioural therapy (CBT) among 4,469 adults in Japan (RESiLIENT trial, UMIN-CTR UMIN000047124). Participants received one of nine CBT skills or combinations, or a health information control (HI), over six weeks.

Exercise-induced brachial-ankle pulse wave velocity changes before and after transcatheter aortic valve replacement.

Elevated arterial stiffness is associated with cardiovascular risk. Brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, is decreased by exercise stress, which is associated with good vascular endothelial function. Moreover, baPWV may predict outcomes following transcatheter aortic valve replacement (TAVR) and has been reported to change before and after TAVR.

Prognostic Value of Periprocedural Pulmonary Artery Pulsatility Index in Patients After Transcatheter Aortic Valve Replacement.

Background: The pulmonary artery pulsatility index (PAPi) is a hemodynamic index that reflects right ventricular function. However, the association between PAPi and prognosis in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) remains unclear.

Objectives: This study aimed to determine how periprocedural changes in the PAPi are associated with patients' prognosis after TAVR.

Risk classification by pathological and biochemical prognostic factors determined by extensive exploration for metastatic hormone sensitive prostate cancer.

Purpose: To determine prognostic parameters, we extensively examined whether physical, biochemical, and histological factors were associated with clinical outcomes in metastatic hormone sensitive prostate cancer (mHSPC) patients.

Methods: A total 822 mHSPC patients were retrospectively investigated and examined the associations between prognosis and clinicopathological parameters including BMI, initial PSA level, TNM classification, Hb, Alb, CRP, AST, ALT, LDH, ALP, Gleason grade group, and EOD score.

Results: According to the CHAARTED criteria, 338 (41.

Modified Glasgow prognostic score predicts outcomes of tyrosine kinase inhibitor monotherapy and immune checkpoint inhibitor combination therapy for metastatic renal cell carcinoma.

Purpose: Tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI) are standard treatments for metastatic renal cell carcinoma (mRCC). the modified Glasgow prognostic score (mGPS) was suggested as one of promising biomarkers. This study evaluated the clinical utility of mGPS in patients with mRCC receiving TKI and ICI therapy and investigated the differential impact of TKI monotherapy and ICI combination therapy on treatment outcomes.

Serum cytokine profiling differentiates underlying diseases in cytokine storm syndrome.

Objective: Cytokine storm syndrome (CSS), commonly associated with hemophagocytic lymphohistiocytosis (HLH), is a fatal hyperinflammatory syndrome. Differentiating the underlying diseases responsible for CSS is essential for timely therapeutic decisions. This study explored the clinical usefulness of serum cytokine profiling in distinguishing underlying diseases in patients with CSS.

Investigating the patterns of renal function variability in early-stage chronic kidney disease by cluster analysis.

Background: Chronic kidney disease (CKD) is a significant global health concern, with increasing focus on predicting renal prognosis. While renal prognosis is often studied in advanced CKD, variability in renal function and its implications for long-term outcomes in early-stage CKD remain insufficiently examined. This study aimed to investigate renal prognosis in early-stage CKD within the general population, focusing on patterns of renal function variability and factors associated with high variability.

Risk stratification of major arrhythmia events in Japanese patients with Brugada syndrome using machine learning models.

Background: Brugada syndrome (BrS) has been known to cause fatal arrhythmias, and an effective risk stratification method should be developed.

Objective: This study aimed to construct a risk prediction model for BrS using machine learning models.

Methods: We enrolled 234 Japanese patients with BrS and analyzed the clinical information including the age, gender, history of syncope, family history of BrS or sudden cardiac death, PR interval in lead Ⅱ, QRS duration in V6, RR interval in V1, r-J interval in V1, T-peak-to-T-end interval, max QTc, fragmented QRS, Type-1 in peripheral leads, spontaneous type 1 pattern, aVR sign, presence of early repolarization (ER), and presence of ER in the peripheral leads.

Prevalence, Mechanisms, and Prognostic Impact of Effort Intolerance in Patients With Asymptomatic/Minimally Symptomatic Aortic Stenosis.

Background: We aimed to investigate the prevalence and prognostic impact of effort intolerance in patients with asymptomatic/minimally symptomatic aortic stenosis and to study its determinants.

Methods And Results: One hundred four patients with at least moderate asymptomatic/minimally symptomatic aortic stenosis (median age 79 years, 57% male) underwent 2-dimensional speckle tracking echocardiography and exercise-stress echocardiography with cardiopulmonary exercise test. Results indicated that 73% of patients have effort intolerance defined as %predicted peak V<70%.

Comprehensive Conservative Kidney Management among Older Population: A Nationwide Administrative Claims Database Analysis.

Background: In an aging society, conservative kidney management (CKM) has emerged as an alternative to renal replacement therapy (RRT) for older patients with advanced chronic kidney disease (CKD). However, current evidence regarding CKM selection and its outcomes is limited. This study compared the rates of hospitalization and survival in CKM cases to those of RRT in the older Japanese general population with advanced CKD.

Longitudinal Analysis of Somatic Mosaicism and Clonal Hematopoiesis in Cryopyrin-Associated Periodic Syndrome.

Objective: Cryopyrin-associated periodic syndrome (CAPS) is an autoinflammatory disease caused by gain-of-function mutations in NLRP3. Although somatic NLRP3 mosaicism is increasingly recognized, it remains unclear how variant allele frequency (VAF) changes over time and whether disease onset age reflects differences in somatic mutation dynamics. This study aimed to analyze the longitudinal VAF trends and their correlation with clonal hematopoiesis (CH) in patients with CAPS mosaicism.

The Utility of Evaluating Primary Stability of Implants Using Accumulated Insertion Torque Values: a Preliminary Study.

Objectives: This preliminary study aimed to clarify the usefulness of the accumulated torque value as a new method for evaluating primary implant stability.

Material And Methods: Implants of different sizes (42-10ST and 37-6ST) and simulated bone blocks of different densities (D1 to D4) were used. The implant osteotomy was prepared following the manufacturer's drilling protocol in simulated bone blocks, and the implants were inserted (n = 10).

Relationship Between Changes in Brain Natriuretic Peptide Levels After Initiation of Peritoneal Dialysis and Duration of Peritoneal Dialysis Monotherapy: A Retrospective Observational Study.

Background Peritoneal dialysis (PD) is an integral modality in renal replacement therapy. However, inadequate fluid volume control is a key reason for PD withdrawal. Brain natriuretic peptide (BNP) is effective for evaluating fluid volume in PD patients.

The Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Reducing Repeated Heart Failure Rehospitalizations Among Elderly Patients With Acute Decompensated Heart Failure: The ROSES-HF Study.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown efficacy in reducing heart failure (HF) hospitalizations and cardiovascular mortality in patients with chronic heart failure, across a range of ejection fractions. However, data on their long-term efficacy in preventing recurrent hospitalization after acute decompensated heart failure (ADHF) in elderly patients are limited. This study aimed to assess the long-term effect of SGLT2i on recurrent HF hospitalization in patients aged ≥75 years following their initial ADHF admission.

Impacts of surface characteristics on biological responses and biofilm formation of 3D-printed denture base resins: An in vitro study.

Background/purpose: With advancements in digital technology, fully digital workflow for complete denture fabrication using 3D-printed denture base resin (DBR) has gained increasing clinical acceptance in recent years. However, the surface characteristics, biocompatibility, and biofilm formation of 3D-printed DBR materials remain insufficiently understood. Therefore, in this study, we investigated and analyzed these aspects.

Bilateral Vertebral Artery Dissection in the V1 and V4 Segments Induced by Artery Anomalies and Risk Factors.

Bilateral vertebral artery dissection (VAD) is rare, particularly in the extracranial V1 segment. We report a case of bilateral VAD (V1 and V4 segments) in a patient with a vertebral artery anomaly, potentially triggered by the puerperium and high pillow use. A 35-year-old primiparous woman with a history of migraine developed worsening headaches after starting to use a high pillow.

Impact of Impaired Renal Function on the Efficacy and Safety of Second-Line Tyrosine Kinase Inhibitor Therapy After First-Line Immuno-Oncology Combination Therapy in Metastatic Renal Cell Carcinoma: A Japanese Multicenter Retrospective Study.

Objectives: To evaluate the effects of renal impairment at the time of second-line tyrosine kinase inhibitor (TKI) therapy initiation and rapid renal function decline during first-line immuno-oncology (IO) combination therapy on metastatic renal cell carcinoma (mRCC) patients treated with second-line TKIs.

Methods: This multicenter retrospective study included 243 mRCC patients treated with first-line IO combination therapy, followed by second-line TKI therapy. Patients were divided into three groups using the estimated glomerular filtration rate (eGFR; mL/min/1.

Expert consensus on diagnostic guidelines for pediatric inflammatory bowel disease in Japan.

Background: Inflammatory bowel disease (IBD) can occur at any age. In pediatric patients, the disease may present with a broader range of symptoms and more severe course than in adults, due to ongoing growth and development. Therefore, pediatric IBD often exhibits an atypical clinical course and laboratory findings.