The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Jan 2020
The Risk of Developing Multiple Primary Cancers among Long-Term Survivors Five Years or More after Stomach Carcinoma Resection.
Recently, the number of long-term survivors of ≥ 5 years after stomach carcinoma resection is increasing in Japan. The clinical courses of 4,883 patients who underwent stomach carcinoma resection were retrospectively reviewed to investigate the cause of death including multiple primary cancers (MPC) and delayed stomach carcinoma recurrence among long-term survivors of ≥ 5 years. Of 3,061 patients who survived for ≥ 5 years, 1,203 patients (39.3%) were dead after 5 years survival, including 299 patients (24.9%) who died of MPC. ⋯ In conclusion, MPC accounted for approximately a quarter of the cause of death in long-term survivors. Lifestyle instructions including smoking cessation are important. Periodical cancer screening allows the early asymptomatic diagnosis and may contribute to a decrease in cancer mortality of MPC in long-term cancer survivors.
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Tohoku J. Exp. Med. · Jan 2020
Efficacy and Safety of Targeted Strategy for Treating Rheumatoid Arthritis Patients Aged 75 Years or Older.
The efficacy and safety of targeted treatment for elderly patients with rheumatoid arthritis (RA) was considered. Patients with RA who met the ACR/EULAR 2010 classification criteria and were treated consecutively for > 3 years, were recruited and classified into three age groups with 10-year increments from 65 years. Treatment protocol that aims to achieve clinical remission within 6 months was commonly adopted. ⋯ However, the prevalence of adverse events, especially serious infection, in the oldest group was higher than that in the younger groups, which was likely attributable to the higher frequency of administration of glucocorticoid steroid after minimum disease activity obtained and higher prevalence of cardiovascular comorbidities. Targeted treatment is feasible even for patients aged ≥ 75. However, glucocorticoid steroid administration is considered as a risk of adverse events and should be tapered immediately.
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Tohoku J. Exp. Med. · Jan 2020
Preventive Effect of Tonsillectomy on Recurrence of Henoch-Schönlein Purpura Nephritis after Intravenous Methylprednisolone Pulse Therapy.
Henoch-Schönlein purpura (HSP) is regarded as a benign and self-limiting vasculitis characterized by purpura, arthritis, and gastrointestinal symptoms; however, about one third of the patients develop HSP nephritis (HSPN), the most serious long-term complication. Since 2013, we have proposed that tonsillectomy in addition to intravenous methylprednisolone pulse therapy (IVMP) be performed in all patients with HSPN, similar to immunoglobulin A nephropathy (IgAN) patients because both diseases are considered to a share common pathogenesis. ⋯ For the 2 years after IVMP therapy, the rate of HSPN recurrence (i.e., persistent proteinuria combined with hematuria requiring additional treatments) after clinical remission was significantly lower in the tonsillectomy group than the IVMP group (0% vs. 19%, P < 0.05). Despite the short follow-up period in the tonsillectomy group, this study provides the evidence that tonsillectomy may be beneficial for preventing recurrence of HSPN from clinical remission with IVMP therapy in Japanese children.