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https://www.readbyqxmd.com/read/28210765/refractory-long-term-cholangitis-after-pancreaticoduodenectomy-a-retrospective-study
#1
Hiroki Ueda, Daisuke Ban, Atsushi Kudo, Takanori Ochiai, Shinji Tanaka, Minoru Tanabe
BACKGROUND: Postoperative cholangitis is one of the major late complications after pancreaticoduodenectomy (PD), and recurrent cholangitis has a negative impact on patients' quality of life. However, detailed reports are scarce. The aim of this study was to investigate the clinical features of postoperative cholangitis after PD. METHODS: Between January 2007 and December 2013, 155 consecutive patients underwent PD. Of these, 113 patients were included in this study...
February 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28149138/role-of-procalcitonin-in-evaluation-of-the-severity-of-acute-cholecystitis
#2
Yucel Yuzbasioglu, Hikmet Duymaz, Ceren Sen Tanrikulu, Huseyin Cahit Halhalli, Mirac Ozturk Koc, Meral Tandoğan, Figen Coskun
OBJECTIVE: The aim of this study is to investigate the relationship between procalcitonin (PCT) level and the severity of acute cholecystitis. MATERIALS AND METHODS: This study included 200 patients diagnosed with acute cholecystitis. To diagnose and assess the severity of acute cholecystitis; physical examination and abdominal ultrasound findings were evaluated and blood samples were taken to determine white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and levels of coagulation factors, blood gas, C-reactive protein (CRP) and PCT...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28127715/the-optimal-treatment-of-patients-with-mild-and-moderate-acute-cholecystitis-time-for-a-revision-of-the-tokyo-guidelines
#3
Charlotte S Loozen, Maaike M Blessing, Bert van Ramshorst, Hjalmar C van Santvoort, Djamila Boerma
INTRODUCTION: According to the Tokyo Guidelines, severity of acute cholecystitis is divided into three grades based on the degree of inflammation and the presence of organ dysfunction. These guidelines recommend grade I (mild) acute cholecystitis to be treated with early laparoscopic cholecystectomy and grade II (moderate) acute cholecystitis with delayed cholecystectomy. Yet, several studies have shown that, for acute cholecystitis in general, early cholecystectomy is superior to delayed cholecystectomy in terms of complication rate, duration of hospital stay and costs...
January 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28070114/development-of-database-and-genomic-medicine-for-von-hippel-lindau-disease-in-japan
#4
Shunsaku Takayanagi, Akitake Mukasa, Hirofumi Nakatomi, Hiroshi Kanno, Jun-Ichi Kuratsu, Ryo Nishikawa, Kazuhiko Mishima, Atushi Natsume, Toshihiko Wakabayashi, Kiyohiro Houkin, Shunsuke Terasaka, Masahiro Yao, Nobuo Shinohara, Taro Shuin, Nobuhito Saito
von Hippel-Lindau (VHL) disease is a hereditary tumor disease in which tumors develop in multiple organs, not only as hemangioblastomas (HBs) in the central nervous system, but also as kidney tumors, pheochromocytomas, and so on. Much about the epidemiology of VHL disease remained unknown until fairly recently in Japan, leading to calls for the establishment of a VHL disease epidemiological database in Japanese. To elucidate its epidemiology in Japan, the Japanese Ministry of Health, Labour and Welfare created the VHL Disease Study Group, which was put in charge of carrying out a nationwide epidemiological survey...
January 6, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28069529/outcomes-in-older-patients-with-grade-iii-cholecystitis-and-cholecystostomy-tube-placement-a-propensity-score-analysis
#5
Francesca M Dimou, Deepak Adhikari, Hemalkumar B Mehta, Taylor S Riall
BACKGROUND: The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. STUDY DESIGN: We used Medicare data (1996 to 2010) to identify patients 66 years and older who were admitted with grade III acute cholecystitis. We evaluated adherence to the Tokyo Guidelines and compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a propensity-matched (1:3) cohort of patients with grade III cholecystitis...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28063415/efficacy-of-preoperative-percutaneous-cholecystostomy-in-the-management-of-acute-cholecystitis-according-to-severity-grades
#6
Seong Yeol Kim, Kyo-Sang Yoo
Background/Aims: The aim of this retrospective study was to assess the efficacy of percutaneous cholecystostomy (PC) for patients with acute cholecystitis (AC) according to severity. Methods: A total of 325 patients who underwent cholecystectomy between January 2008 and October 2010 were enrolled. Patients were classified into three groups based on severity grade according to the Tokyo guidelines for AC: grade I (mild), grade II (moderate), and grade III (severe)...
January 6, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28027992/short-course-antimicrobial-treatment-for-acute-cholangitis-with-gram-negative-bacillary-bacteremia
#7
Shunsuke Uno, Ryota Hase, Masayoshi Kobayashi, Toshiyasu Shiratori, So Nakaji, Nobuto Hirata, Naoto Hosokawa
OBJECTIVES: The optimal antimicrobial treatment duration for patients with acute cholangitis with bacteremia remains unknown. The updated Tokyo Guidelines 2013 recommend a minimum duration of 2 weeks only when bacteremia with Gram-positive cocci is present. Since May 2013, a shorter antimicrobial treatment duration of under 2 weeks has been implemented at the authors' institution for acute cholangitis with Gram-negative bacillary bacteremia. The aim of the present study was to validate this modified practice...
December 24, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28024739/pneumococcal-biliary-tract-infections-how-rare-are-they
#8
Hiroshi Morioka, Mitsutaka Iguchi, Mitsuru Oodate, Masaki Yoneda, Futoshi Ushijima, Aki Hirabayashi, Nobuyuki Tetsuka, Yuka Tomita, Daizo Kato, Tetsuya Yagi
Pneumococcal biliary tract infections (PBTIs) were reported as rare due to the bacterium's bile solubility. The purpose of this study was to determine the occurrence and clinical characteristics of PBTIs. A retrospective case series review was conducted from January 2006 to August 2014 at a tertiary referral university hospital in Japan. Patients with a blood or bile culture positive for Streptococcus pneumoniae diagnosed with definite cholangitis or cholecystitis according to Tokyo Guideline 2013 were enrolled in this study...
December 23, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27904248/percutaneous-cholecystostomy-evidence-based-current-clinical-practice
#9
REVIEW
Karan Gulaya, Shamit S Desai, Kent Sato
The role of percutaneous cholecystostomy (PC) in the management of acute cholecystitis and cholangitis is outlined in the revised 2013 Tokyo Guidelines. These two emergencies constitute the vast majority of PC performed today for therapeutic purposes, and research has repeatedly shown the utility of PC in these conditions. PC is typically employed in the management of critically ill patients who are not surgical candidates. Indications and contraindications to PC are reviewed. Additional innovative applications of PC have been developed since it was first described in 1980...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27859597/quality-of-care-for-people-with-dementia-and-professional-caregivers-perspectives-regarding-palliative-care-in-japanese-community-care-settings
#10
Miharu Nakanishi, Kayo Hirooka, Yuko Morimoto, Atsushi Nishida
OBJECTIVE: Palliative care for dementia includes psychosocial interventions as first-line treatment for challenging behaviour. However, the national dementia plan in Japan contradicts recommendations for palliative care for dementia. This study aimed to examine the association between care quality for patients with dementia and professional caregivers' perspectives regarding palliative care for dementia in Japanese community care settings. METHODS: In total, 2116 professional caregivers from 329 agencies (217 in-home long-term care support providers; 29 small-scale, multiple home-care providers; and 83 group homes) in Tokyo prefecture, Japan, completed cross-sectional, paper-based questionnaires about 3603 people diagnosed with dementia, in May 2016...
November 17, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27834012/postoperative-complications-of-laparoscopic-cholecystectomy-for-acute-cholecystitis-a-comparison-to-the-acs-nsqip-risk-calculator-and-the-tokyo-guidelines
#11
Roxanne L Massoumi, Colleen M Trevino, Travis P Webb
BACKGROUND: We compared observed postoperative outcomes from laparoscopic cholecystectomy performed for acute cholecystitis (AC) to outcomes predicted by the ACS-NSQIP risk calculator.We also noted and compared any differences in observed outcomes across the different Tokyo Guidelines (TG) levels of AC severity.We hypothesized that ACS-NSQIP would accurately predict complications and length of stay (LOS) and that increased TG severity levels would correlate with more complications, increased conversion to open surgery, and longer LOS...
November 10, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27804044/tokyo-guidelines-2013-may-be-too-restrictive-and-patients-with-moderate-and-severe-acute-cholecystitis-can-be-managed-by-early-cholecystectomy-too
#12
Vinoban Amirthalingam, Jee Keem Low, Winston Woon, Vishalkumar Shelat
OBJECTIVE: The aim of this study was to determine whether early laparoscopic cholecystectomy (LC) is safe and feasible for patients diagnosed with moderate (grade 2) and severe (grade 3) acute cholecystitis (AC) according to the Tokyo Guidelines 2013 (TG13). BACKGROUND: Early cholecystectomy is the current accepted standard of care for patients with mild (grade 1) and selected grade 2 AC based on TG13. For selected grade 2 and grade 3 AC, early percutaneous cholecystostomy (PC) followed by delayed cholecystectomy is recommended...
November 1, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27802304/evaluation-of-risk-perception-and-risk-comparison-information-regarding-dietary-radionuclides-after-the-2011-fukushima-nuclear-power-plant-accident
#13
Michio Murakami, Jun Nakatani, Taikan Oki
In the wake of the 2011 Fukushima Daiichi Nuclear Power Station accident, to facilitate evidence-based risk communication we need to understand radiation risk perception and the effectiveness of risk-comparison information. We measured and characterized perceptions of dread risks and unknown risks regarding dietary radionuclides in residents of Fukushima, Tokyo, and Osaka to identify the primary factors among location, evacuation experience, gender, age, employment status, absence/presence of spouse, children and grandchildren, educational background, humanities/science courses, smoking habits, and various types of trustworthy information sources...
2016: PloS One
https://www.readbyqxmd.com/read/27783206/procalcitonin-is-a-useful-biomarker-to-predict-severe-acute-cholangitis-a-single-center-prospective-study
#14
Gyotane Umefune, Hirofumi Kogure, Tsuyoshi Hamada, Hiroyuki Isayama, Kazunaga Ishigaki, Kaoru Takagi, Dai Akiyama, Takeo Watanabe, Naminatsu Takahara, Suguru Mizuno, Saburo Matsubara, Natsuyo Yamamoto, Yousuke Nakai, Minoru Tada, Kazuhiko Koike
BACKGROUND: Procalcitonin is being increasingly used to diagnose and grade acute systemic bacterial infection at an early stage of disease onset. The aim of this prospective study was to evaluate the usefulness of procalcitonin for severity grading of acute cholangitis on patient admission. METHODS: Patients with acute cholangitis were prospectively enrolled. The severity of acute cholangitis was graded on the basis of the 2013 Tokyo guidelines (Japanese Society of Hepato-Biliary-Pancreatic Surgery, 2013)...
October 25, 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27775259/major-clinical-research-advances-in-gynecologic-cancer-in-2015
#15
REVIEW
Dong Hoon Suh, Miseon Kim, Hak Jae Kim, Kyung Hun Lee, Jae Weon Kim
In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed...
November 2016: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/27704274/risk-adjusted-treatment-selection-and-outcome-of-patients-with-acute-cholecystitis
#16
J I González-Muñoz, G Franch-Arcas, M Angoso-Clavijo, M Sánchez-Hernández, A García-Plaza, M Caraballo-Angeli, L Muñoz-Bellvís
PURPOSE: Age and comorbidities increase the surgical risk for patients with acute cholecystitis and impact on the initial treatment selection. The aim of this article is the implementation of objective risk criteria that may be used to select the most appropriate treatment. METHODS: We carried out a prospective cohort study of all patients who were admitted to the hospital with a diagnosis of acute cholecystitis during 2014. They were initially allocated to three different treatment groups according to cholecystitis grade, number of days from clinical onset, and surgical risk scores as follows: immediate surgery by sepsis (EmergS), early surgery (EarlyS), or medical treatment group (MedT)...
October 4, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27649967/autoimmune-liver-diseases-in-the-asia-pacific-region-proceedings-of-apasl-symposium-on-aih-and-pbc-2016
#17
REVIEW
Atsushi Tanaka, Xiong Ma, Osamu Yokosuka, Martin Weltman, Hong You, Deepak N Amarapurkar, Yoon Jun Kim, Zaigham Abbas, Diana A Payawal, Ming-Ling Chang, Cumali Efe, Ersan Ozaslan, Masanori Abe, Robert Mitchell-Thain, Mikio Zeniya, Kwang Hyub Han, John M Vierling, Hajime Takikawa
During the 25th annual meeting of the Asia-Pacific Association for the Study of the Liver (APASL 2016) in Tokyo, we organized and moderated an inaugural satellite symposium on the autoimmune liver diseases, autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Following the keynote lecture by John M. Vierling (USA), speakers from the Asia-Pacific region provided an up-to-date perspective on the epidemiology, clinical practice and research in AIH and PBC in the Asia-Pacific region. Although epidemiology and clinical features of AIH seem to be similar in East Asia compared to those in western countries, the majority of patients with AIH are detected at an advanced stage and have higher mortality rates in South Asia, indicating an unmet need for earlier diagnosis and the initiation of appropriate immunosuppressive treatment...
November 2016: Hepatology International
https://www.readbyqxmd.com/read/27624277/7th-japan-bioanalysis-forum-symposium-regulated-bioanalysis-to-a-new-stage
#18
Takahiro Nakamura
Tower Hall Funabori, Tokyo, Japan, 9-10 March 2016 At the 7th Japan Bioanalysis Forum symposium, bioanalytical methods and processes were discussed with authorities after the issuing of bioanalytical method validation guidelines (EMA and Japanese Ministry of Health, Labour and Welfare) and draft guidance (US FDA). Method establishment and bioanalysis of biomarkers were discussed with a focus on scientific validation. Bioanalytical methods for antibody-drug conjugates, the potential of MS imaging and microsampling activity in drug development were introduced...
October 2016: Bioanalysis
https://www.readbyqxmd.com/read/27557050/association-of-admission-laboratory-values-and-the-timing-of-endoscopic-retrograde-cholangiopancreatography-with-clinical-outcomes-in-acute-cholangitis
#19
Alexander C Schwed, Monica M Boggs, Xuan-Binh D Pham, Drew M Watanabe, Michael C Bermudez, Amy H Kaji, Dennis Y Kim, David S Plurad, Darin J Saltzman, Christian de Virgilio
Importance: Acute cholangitis (AC), particularly severe AC, has historically required urgent endoscopic decompression, although the timing of decompression is controversial. We previously identified 2 admission risk factors for adverse outcomes in AC: total bilirubin level greater than 10 mg/dL and white blood cell count greater than 20 000 cells/µL. Objectives: To validate previously identified prognostic factors in AC, evaluate the effect of timing of endoscopic retrograde cholangiopancreatography on clinical outcomes, and compare recent experience with AC vs an historical cohort...
November 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27556102/clinical-features-of-gallstone-impaction-at-the-ampulla-of-vater-and-the-effectiveness-of-endoscopic-biliary-drainage-without-papillotomy
#20
Yuichi Takano, Masatsugu Nagahama, Naotaka Maruoka, Eiichi Yamamura, Nobuyuki Ohike, Tomoko Norose, Hiroshi Takahashi
BACKGROUND AND STUDY AIMS: Gallstone impaction at the ampulla of Vater is a critical condition, and the standard treatment is endoscopic papillotomy. However, the clinical features remain largely unclear, and some patients are reluctant to undergo papillotomy because of a bleeding tendency. The aim of this study was to clarify the clinical features of gallstone impaction at the ampulla of Vater and to examine the effectiveness of endoscopic biliary drainage without papillotomy. PATIENTS AND METHODS: We retrospectively examined 30 patients who had undergone endoscopic treatment for gallstone impaction at the ampulla of Vater between 2010 and 2015...
July 2016: Endoscopy International Open
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