scholarly journals Analysis of the Long-Term Prognosis in Japanese Patients with Ulcerative Colitis Treated with New Therapeutic Agents and the Correlation between Prognosis and Disease Susceptibility Loci

2021 ◽  
pp. 1-11
Author(s):  
Kasumi Hishinuma ◽  
Rintaro Moroi ◽  
Daisuke Okamoto ◽  
Yusuke Shimoyama ◽  
Masatake Kuroha ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Multivariate Analysis ◽  
Poor Response ◽  
Japanese Patients ◽  
Therapeutic Agents ◽  
Aminosalicylic Acid ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Long Term Prognosis

<b><i>Background:</i></b> New therapeutic agents, including biologics and small-molecule drugs, are widely used to treat ulcerative colitis (UC). This study evaluates long-term prognosis in Japanese patients treated with these agents and the association between prognosis and genetic susceptibility to UC. <b><i>Methods:</i></b> We evaluated surgery-free rates using the Kaplan-Meier method in the total cohort and in patients treated with prednisolone and new therapeutic agents. Multivariate analysis was performed to identify clinical factors affecting surgical rates using Cox’s proportional hazard model. The rate of use of new therapeutic agents was compared using the Kaplan-Meier method, and multivariate analysis was conducted to investigate the correlation between the single-nucleotide polymorphism (SNP) rs117506082 and long-term prognosis. <b><i>Results:</i></b> Surgery-free survival decreased over time. There was no significant difference in this parameter between patients who were administered prednisolone and those who were administered new therapeutic agents. Poor response to prednisolone and treatment without topical 5-aminosalicylic acid were poor prognostic factors. Shorter time from diagnosis to initiation of treatment with new therapeutic agents was a risk factor for colectomy. The AA genotype of SNP rs117506082 was associated with a shorter time to surgery and increased use of new therapeutic agents. <b><i>Conclusions:</i></b> The use of new therapeutic agents might improve long-term prognosis in patients with more severe UC. Previously identified genetic risk factors were not significantly associated with a higher rate of colectomy.

scholarly journals Influence of ultrasound-guided fine needle aspiration biopsy on cervical lymph node metastasis and prognosis of papillary thyroid microcarcinoma

2021 ◽  
Author(s):  
Ding Min ◽  
Zhifeng Zhao ◽  
Dan Xu ◽  
Tingyu Lin ◽  
Dongjie Shen ◽  
...  
Keyword(s):  
Cervical Lymph Node ◽  
Thyroid Nodules ◽  
Cervical Lymph Node Metastasis ◽  
Papillary Thyroid ◽  
Node Metastasis ◽  
Thyroid Microcarcinoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Long Term Prognosis

Abstract Purpose To analyze the potential association between UGFNA and cervical lymph node metastasis (CLNM) of papillary thyroid microcarcinoma (PTMC) and whether it would influence the long-term prognosis of PTMC. Then we could give advice for the application of UGFNA for thyroid nodules less than 1cm. Methods A total of 367 adult patients with PTMC who underwent thyroidectomy in our hospital during January 2014 and December 2015 were enrolled in this retrospective cohort study. Univariate and multivariate analysis were conducted to explore the potential risk factors of CLNM. Propensity score (PS) matching was performed to select patients with homogeneous baseline characteristics. Then the rate of CLNM was compared in matched samples by chi-squared (χ2). Survival analysis was made by Kaplan-Meier method in PS-matching cohort. Results CLNM rate in PS-matching cohort showed no significant difference between UGFNA group and non-UGFNA group. (29.5% vs 23.7%, P>0.05). Multivariate analysis showed that male sex (OR=3.997, 95%CI 2.148~7.439, P<0.01), larger tumor size (OR=2.319, 95%CI 1.285~4.186, P<0.01) were independent risk factors of CLNM. With a median follow-up of 63.8 months (range 3.1-84.9 months), the 5-year cumulative recurrence-free survival (RFS) rate was 99.3% in UGFNA group and 97.7% in non-UGFNA group. After PS-matching, Kaplan-Meier curves showed no significant difference from each other (P >0.05). Conclusions UGFNA was a very safe diagnostic tool, which would not influence the CLNM rate and long-term prognosis of patients with PTMC. Regardless of the costs, we recommend routine UGFNA for suspicious thyroid nodules ≦1cm.

scholarly journals Predictive factors of relapse after dose reduction of oral 5-aminosalicylic acid in patients with ulcerative colitis in the remission phase

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255620
Author(s):  
Akira Madarame ◽  
Masakatsu Fukuzawa ◽  
Yoshiya Yamauchi ◽  
Shin Kono ◽  
Akihiko Sugimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Dose Reduction ◽  
Clinical Relapse ◽  
Aminosalicylic Acid ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Significant Difference ◽  
History Of

Objectives Useful indices to determine whether to reduce the dose of 5-aminosalicylic acid (5-ASA) in patients with ulcerative colitis (UC) during remission remain unclear. We aimed to analyze the rate and risk factors of relapse after reducing the dose of oral 5-ASA used for maintenance therapy of UC. Methods UC patients whose 5-ASA dose was reduced in clinical remission (partial Mayo score of ≤ 1) at our institution from 2012 to 2017 were analyzed. Various clinical variables of patients who relapsed after reducing the dose of oral 5-ASA were compared with those of patients who maintained remission. Risk factors for relapse were assessed by univariate and multivariate logistic regression analyses. Cumulative relapse-free survival rates were calculated using the Kaplan–Meier method. Results A total of 70 UC patients were included; 52 (74.3%) patients maintained remission and 18 (25.7%) patients relapsed during the follow-up period. Multivariate analysis indicated that a history of acute severe UC (ASUC) was an independent predictive factor for clinical relapse (p = 0.024, odds ratio: 21, 95% confidence interval: 1.50–293.2). Based on Kaplan–Meier survival analysis, the cumulative relapse-free survival rate within 52 weeks was 22.2% for patients with a history of ASUC, compared with 82.0% for those without. the log-rank test showed a significant difference in a history of ASUC (p < 0.001). Conclusions Dose reduction of 5-ASA should be performed carefully in patients who have a history of ASUC.

scholarly journals Immunomodulators and Immunosuppressants for Japanese Patients with Ulcerative Colitis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Shigeki Bamba ◽  
Tomoyuki Tsujikawa ◽  
Masaya Sasaki ◽  
Yoshihide Fujiyama ◽  
Akira Andoh
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Importance ◽  
Japanese Patients ◽  
Multidrug Resistance Protein ◽  
Aminosalicylic Acid ◽  
Steroid Dependent ◽  
Resistance Protein ◽  
Chronic Course ◽  
Steroid Refractory

Ulcerative colitis (UC) is characterized by a long-standing chronic course with remissions and exacerbations. Previously, patients do not respond to 5-aminosalicylic acid compounds and corticosteroids are considered for colectomies, however, in recent years, alternative treatments emerged for steroid-refractory or steroid-dependent UC. In this review article, we focus on immunomodulators (such as azathioprine [AZA] and 6-mercaptopurine [6-MP]) and immunosuppressants (such as cyclosporine A [CSA] and tacrolimus [FK506]) for steroid-refractory or steroid-dependent ulcerative colitis. The characteristics, efficacy and adverse effects of these drugs are outlined. Although the randomized trial of FK506 is conducted in Japan, the clinical data of CSA in Japanese patients are limited. The short-, mid- and long-term follow-ups of CSA administration in Japanese patients are discussed. As for thipurine drugs, the clinical importance of multidrug-resistance protein 4 (MRP4) in Japanese patients is highlighted.

Clinical course and long-term prognosis of Japanese patients with ulcerative colitis

1991 ◽  
Vol 26 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Nobuo Hiwatashi ◽  
Hideo Yamazaki ◽  
Mitsuo Kimura ◽  
Tomizou Morimoto ◽  
Hikaru Watanabe ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Course ◽  
Japanese Patients ◽  
Long Term Prognosis

Tu1983 The Investigation of Medium- to Long-Term Prognosis of Ulcerative Colitis Patients Using Ulcerative Colitis Endoscopic Index of Severity (UCEIS)

2016 ◽  
Vol 150 (4) ◽  
pp. S997
Author(s):  
Mari Arai ◽  
Makoto Naganuma ◽  
Shinya Sugimoto ◽  
Hiroki Kiyohara ◽  
Keiko Ohno ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Index Of Severity ◽  
Long Term Prognosis

SP6.1.11 The Effect of the Enhanced Recovery Programme for Liver Surgery on Long Term Survival

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kalaiyarasi Arujunan ◽  
Abdulwarith Shugaba ◽  
Harmony Uwadiae ◽  
Joel Lambert ◽  
Georgios Sgourakis ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Liver Surgery ◽  
Patient Survival ◽  
Enhanced Recovery ◽  
Readmission Rates ◽  
Term Survival ◽  
Significant Difference

Abstract Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on long term survival has yet to be established. The aim of this study was to determine the effect of the ERPLS on 5-year patient survival. Methods This was a retrospective study of patients who underwent liver resection for colorectal liver metastasis (CRLM) between January 2011 and December 2016 at a regional hepatobiliary centre. The cohort comprised of 60 pre-ERPLS and 60 post-ERPLS patients. The primary outcome was 5-year patient survival. The secondary outcomes were length of stay (LOS), postoperative complications and 90-day readmission rates. Multivariate analysis was performed to identify independent predictors of overall survival. Results There was no significant difference in the age (p = 0.960), gender (p = 0.332) and type of resection (p = 0.198) between both groups. ERPLS was not an independent predictor for overall survival (Gehan Wilcoxon Test, p = 0.828). There was no significant difference in the LOS (p = 0.874) and 90-day readmission rates (p = 0.349). Major postoperative complications (&gt;3a Clavien-Dindo classification) were significantly less in the ERPLS group (p = 0.02). On multivariate analysis, positive resection margins and major postoperative complications were independent predictors for overall survival. Conclusions ERPLS does not seem to have an effect on long term patient survival. However, it appears to reduce the rate of major postoperative complications. LOS and 90-day readmission rates were not influenced by ERPLS.

scholarly journals A Comparison of Short- and Long-Term Therapeutic Outcomes of Infliximab- versus Tacrolimus-Based Strategies for Steroid-Refractory Ulcerative Colitis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Katsuya Endo ◽  
Motoyuki Onodera ◽  
Hisashi Shiga ◽  
Masatake Kuroha ◽  
Tomoya Kimura ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Therapeutic Efficacy ◽  
Maintenance Treatment ◽  
Remission Rate ◽  
Rank Test ◽  
Clinical Response Rate ◽  
Therapeutic Outcomes ◽  
Significant Difference ◽  
Steroid Refractory

Background/Aims. Antitumor necrosis factor antibodies and calcineurin inhibitors have shown good therapeutic efficacy for steroid-refractory ulcerative colitis (UC). Although some studies have compared the efficacy of infliximab (IFX) and cyclosporin A, there are no published studies comparing IFX and tacrolimus (Tac). This study aimed to compare therapeutic efficacies between IFX- and Tac-based strategies for steroid-refractory UC.Methods. Between July 2009 and August 2013, 95 patients with steroid-refractory UC received either IFX(n=48)or Tac(n=47)in our hospital. In the IFX group, the patients continued to receive maintenance treatment with IFX. In the Tac group, patients discontinued Tac treatment up to 3 months and subsequently received thiopurine. We retrospectively compared the therapeutic outcomes between the groups.Results. There was no significant difference in the colectomy-free rate, clinical remission rate, and clinical response rate at 2 months between the groups. However, relapse-free survival was significantly higher in the IFX group than in the Tac group (p<0.001; log-rank test). The proportions of serious adverse events did not differ between the groups.Conclusion.The findings of our study showed that IFX and Tac have similar short-term therapeutic efficacy for steroid-refractory UC. Maintenance treatment with IFX, however, yields better long-term outcomes than Tac-thiopurine bridging treatment.

Short and Long Term Outcome In Patients with Calcified Lesions Requiring Rotational Artherectomy

2021 ◽  
Vol 35 (2) ◽  
pp. 140-146
Author(s):  
Lima Asrin Sayami ◽  
Al Fazir Omar ◽  
Sheikh Ziarat Islam ◽  
Subasni Govindan ◽  
Zulaikha Zainal ◽  
...  
Keyword(s):  
P Value ◽  
Success Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Operator Experience ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Short And Long Term ◽  
Procedural Success

Objective: Despite the evolution of interventional techniques and operator experience, percutaneous revascularization of complex coronary lesions especially calcified lesions remains challenging because of lower procedural success and higher restenosis rates. Limited data are available on the effect of rotational atherectomy (RA) plus stenting in the treatment of complex calcified lesions of coronary artery disease. This study was aimed to investigate the characteristics, short and long term outcomes in patients undergoing RA. Material and Methods: A database search was performed from the year 2008 to 2013 in National Heart institute, Malaysia. A total of 16009 patients who underwent PCIs were enrolled in 2 groups, RA group (258 patients) and non RA group (15751 patients). The Chi square test and Kaplan - Meier analysis were used. Results: Male patients (73.6%) and elderly population (63.2%) were predominant in this study.The RA group had more co-morbidities such as diabetic on insulin (34%) and chronic kidney disease (57%). The lesions in RA group were more complex with higher Type C lesion (68.8%) and longer lesion (20.6%) compared to non RA group. Despite higher patient risk profile, the success rate of revascularization remains high in RA group (99.3%) as in non RA group (97%) (p value 0.89%). More importantly there were no significant difference in in-hospital mortality, myocardial infarction and stent thrombosis in both group (p value 0.1). In 1 year Kaplan - Meier survival graph, there were better survival noted in non RA group (97.7%) compare to RA (89.6%) (p value <0.005), Conclusion: The use of RA allows debulking of a calcified lesion and possibly explains the higher acute procedural success rates. However, the lower 1-yearsurvival in the RA group highlights the higher associated baseline comorbitidity in this group. Therefore, besides coronary intervention, this RA group requires aggressive medical therapy through a multi-disciplinary approach. Bangladesh Heart Journal 2020; 35(2) : 140-146

295 DOES TREATMENT INTENSIFICATION FOR ULCERATIVE COLITIS PATIENTS WITH CLINICAL REMISSION WHO HAVE MILD ENDOSCOPIC ACTIVITY IMPROVE LONG-TERM PROGNOSIS?

2019 ◽  
Vol 89 (6) ◽  
pp. AB70-AB71 ◽  
Author(s):  
Shuhei Hosomi ◽  
Shigehiro Itani ◽  
Rieko Nakata ◽  
Naoko Sugita ◽  
Yu Nishida ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Remission ◽  
Treatment Intensification ◽  
Long Term Prognosis

P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A E Moreyra ◽  
Y Yang ◽  
S Zinonos ◽  
N M Cosgrove ◽  
J Cabrera ◽  
...  
Keyword(s):  
Constrictive Pericarditis ◽  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Robert Wood Johnson Foundation ◽  
Open Heart ◽  
Significant Difference ◽  
Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

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