Internal medicine
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Objective Many vascular endothelial growth factor (VEGF) pathway inhibitors are used in the treatment of patients with various advanced cancers; however, treatments induce cardiovascular adverse events (CVAEs), such as hypertension, heart failure, arrhythmia, arterial or venous embolism, and hemorrhage. Some studies have suggested a correlation between efficacy and CVAEs; however, further evidence is required. This study evaluated real-world data concerning the frequency and degree of CVAEs and possible associations between CVAEs and efficacy in such patients. ⋯ Furthermore, the PFS of patients with a CVAE grade ≥3 in the early period was favorable compared to that of those with CVAEs of grades 0-2. Taken together, a higher degree of CVAE was correlated with favorable patient outcomes. Conclusion This study revealed the frequency and degree of CVAEs in patients with solid cancers who received VEGF pathway inhibitors in a real-world setting and added evidence regarding the correlation between CVAEs and efficacy of VEGF pathway inhibitors.
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Objective This study aimed to investigate the antihypertensive goal achievement rate for office blood pressure (OBP) and the rate of clinical inertia (inertia) as factors for non-achievement in hypertensive patients in 2020. After documenting these results in the medical records, we observed changes in the achievement rate of the OBP goals in 2020 and 2022. Methods In Study 1, the participants were 517 outpatients (mean age 68.6±13.2 years, 54% women) who visited the Division of Hypertension regularly between March and September 2020. ⋯ The OBP significantly decreased in 2022 in comparison to 2020. The achievement rate of OBP goals showed an increasing trend from 45% in 2020 to 52% in 2022. Conclusion Attending physicians' awareness of unmet antihypertensive goals can help them overcome inertia and improve blood pressure control in patients.
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A 53-year-old man with chronic dyspnea and bilateral pleural effusion was subsequently diagnosed with idiopathic chylothorax. Lymphatic scintigraphy confirmed lymphatic fluid leakage at the left venous angle, prompting management with lymphaticovenular anastomosis (LVA). ⋯ Approximately three years and three months after the presentation, the patient succumbed to CO2 narcosis and renal failure. It is crucial to study additional cases in order to uncover new causes and develop pathology-based treatments for this condition.
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Recently, transmural naso-cyst continuous irrigation (TNCCI) has been reported as an effective and safe treatment for walled-off necrosis (WON). We herein report a case of bilocular WON that was successfully treated with TNCCI. ⋯ Subsequently, a lumen-apposing metal stent (LAMS) was placed in the main cavity and TNCCI was successfully performed in the subcavity. TNCCI with LAMS was effective in treating bilocular WON.