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  1. Article ; Online: Successful antihypertensive treatment using sacubitril/valsartan alone in a patient with obstructive sleep apnoea syndrome

    Ryuta Sugihara / Yuusaku Sugihara / Itsuko Sugihara / Yasushi Sakata

    Medicina Clínica Práctica, Vol 6, Iss 4, Pp 100393- (2023)

    2023  

    Abstract: Obstructive sleep apnoea syndrome (O-SAS) induces excessive activity of the sympathetic nervous system, resulting in secondary hypertension. Although continuous positive airway pressure (CPAP) is the first-line therapy for O-SAS, poor adherence to CPAP ... ...

    Abstract Obstructive sleep apnoea syndrome (O-SAS) induces excessive activity of the sympathetic nervous system, resulting in secondary hypertension. Although continuous positive airway pressure (CPAP) is the first-line therapy for O-SAS, poor adherence to CPAP induces uncontrollable resistant hypertension. We present a case of O-SAS-related hypertension successfully treated with sacubitril/valsartan alone. Polysomnography before treatment showed a markedly increased apnoea-hypopnoea index (44.8/hour). While receiving treatment with CPAP and azilsartan, his in-office blood pressure remained within the acceptable range (120–130/80–85 mmHg). However, his blood pressure increased again after quitting CPAP. Subsequently, we switched to sacubitril/valsartan alone and succeeded in improving his blood pressure from 145/95 to 120/80 mmHg. Furthermore, sacubitril/valsartan improved sleep quality in terms of blood pressure (from non-dipper type to dipper type) and apnoea-hypopnoea index (38.3/hour). This case indicates that sacubitril/valsartan has great potential for antihypertensive effects in patients with severe O-SAS, even without CPAP. Resumen: El síndrome de apnea obstructiva del sueño (SAOS) induce actividad excesiva del sistema nervioso simpático, ocasionando hipertensión secundaria. Aunque la presión positiva continua en vía respiratoria (CPAP) es el tratamiento inicial para SAOS, mala adherencia a CPAP provoca hipertensión resistente incontrolable. Presentamos un caso de hipertensión relacionada con SAOS tratada exitosamente solo con sacubitril/valsartán. La polisomnografía pre-tratamiento mostró un índice de apnea-hipopnea notablemente aumentado (44,8/hora). Tratando con CPAP y azilsartán, su presión arterial en consultorio permaneció en rango aceptable (120-130/80-85 mmHg). Pero, su presión arterial volvió a aumentar tras dejar la CPAP. Posteriormente, cambiamos a solo sacubitril/valsartán, consiguiendo mejorar su presión arterial (de 145/95 a 120/80 mmHg). Además, sacubitril/valsartán mejoró la calidad de sueño ...
    Keywords síndrome de apnea obstructiva del sueño ; hipertensión ; sacubitril/valsartán ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher Elsevier España
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Peroral endoscopic myotomy is an effective treatment for diffuse esophageal spasm

    Yuusaku Sugihara / Hiroyuki Sakae / Kenta Hamada / Hiroyuki Okada

    Clinical Case Reports, Vol 8, Iss 5, Pp 927-

    2020  Volume 928

    Abstract: Abstract Diffuse esophageal spasm (DES) causes symptoms such as dysphagia. However, DES is sometimes difficult to diagnose. DES can be diagnosed based on a characteristic image through esophageal radiography. As in the present case, DES is considered a ... ...

    Abstract Abstract Diffuse esophageal spasm (DES) causes symptoms such as dysphagia. However, DES is sometimes difficult to diagnose. DES can be diagnosed based on a characteristic image through esophageal radiography. As in the present case, DES is considered a good indication for peroral endoscopic myotomy.
    Keywords diffuse esophageal spasm ; peroral endoscopic myotomy ; Medicine ; R ; Medicine (General) ; R5-920
    Language English
    Publishing date 2020-05-01T00:00:00Z
    Publisher Wiley
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease

    Sakiko Hiraoka / Shiho Takashima / Yoshitaka Kondo / Toshihiro Inokuchi / Yuusaku Sugihara / Masahiro Takahara / Seiji Kawano / Keita Harada / Jun Kato / Hiroyuki Okada

    Intestinal Research, Vol 16, Iss 1, Pp 75-

    2018  Volume 82

    Abstract: Background/AimsThe efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn's disease (CD) in patients who were treated with these agents prior to surgery is largely unknown.MethodsCD patients who underwent intestinal ... ...

    Abstract Background/AimsThe efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn's disease (CD) in patients who were treated with these agents prior to surgery is largely unknown.MethodsCD patients who underwent intestinal resection and received anti-TNFα agents after surgery were divided into 2 groups according to the presence or absence of preoperative anti-TNFα treatment: anti-TNFα restart group or anti-TNFα naïve group. Endoscopic recurrence after surgery was examined according to the preoperative conditions, including administration of anti-TNFα agents before surgery.ResultsThirty-six patients received anti-TNFα antibody after surgery: 22 in the anti-TNFα restart group and 14 in the anti-TNFα naïve group. Endoscopic recurrence after surgery was more frequently observed in the anti-TNFα restart group than in the anti-TNFα naïve group (68% vs. 14%, P<0.001). Multivariate analysis revealed the following significant risk factors of endoscopic recurrence after surgery: anti-TNF restart group (odds ratio [OR], 28.10; 95% CI, 3.08–722.00), age at diagnosis <23 years (OR, 24.30; 95% CI, 1.67–1,312.00), serum albumin concentration at surgery <3.3 g/dL (OR, 34.10; 95% CI, 1.72–2,804.00), and presence of inflammation outside of the surgical site (OR, 21.40; 95% CI, 1.02–2,150.00). Treatment intensification for patients with endoscopic recurrence in the anti-TNFα restart group showed limited responses, with only 1 of 12 patients achieving endoscopic remission.ConclusionsThe efficacy of restarting anti-TNFα antibody treatment after surgery was limited, and treatment intensification or a change to different classes of biologics should be considered for those patients.
    Keywords Crohn disease ; Anti-tumor necrosis factor α ; Surgery ; Medicine ; R ; Diseases of the digestive system. Gastroenterology ; RC799-869
    Subject code 616 ; 610
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Korean Association for the Study of Intestinal Diseases
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Depressed-Type Colonic Lesions and “De Novo” Cancer in Familial Adenomatous Polyposis

    Shin-ei Kudo / Yuusaku Sugihara / Hiroyuki Kida / Fumio Ishida / Hideyuki Miyachi / Yuichi Mori / Masashi Misawa / Tomokazu Hisayuki / Kenta Kodama / Kunihiko Wakamura / Takemasa Hayashi / Yoshiki Wada / Shigeharu Hamatani

    ISRN Gastroenterology, Vol

    A Colonoscopist’s Viewpoint

    2013  Volume 2013

    Keywords Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Gastroenterology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher International Scholarly Research Network
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Continuous warfarin administration versus heparin bridging therapy in post colorectal polypectomy haemorrhage

    Yasuaki Nagami / Taishi Sakai / Masafumi Yamamura / Masami Nakatani / Takayuki Katsuno / Takehisa Suekane / Hironori Uno / Hiroaki Minamino / Masatsugu Okuyama / Junichi Okamoto / Mitsutaka Kumamoto / Atsushi Noguchi / Kazuki Yamamori / Osamu Takaishi / Masahiro Ochi / Takako Miyazaki / Shigetsugu Tsuji / Hisatomo Ikehara / Koichiro Kawaguchi /
    Tomoyuki Hayashi / Tomohiko Mannami / Kazuki Kakimoto / Yoshihide Naito / Satoru Hashimoto / Zhaoliang Li / Yoriaki Komeda / Takaaki Kishino / Yoshinobu Yamamoto / Mikitaka Iguchi / Takuji Akamatsu / Toshiki Horii / Ko Miura / Takeshi Yamashina / Yuusaku Sugihara / Noboru Watanabe / Shu Kiyotoki / Ryoji Fujii / Masaki Murata / Satoshi Ono / Toshiaki Narasaka / Shinji Kitamura / Mitsuhiro Kono / Motohiko Kato / Hideto Kawaratani / Kyosuke Tanaka / Takao Yaoita / Shinjiro Yamaguchi / Keiichiro Abe / Takuji Kawamura / Yosuke Kinoshita

    Trials, Vol 22, Iss 1, Pp 1-

    a study protocol for a multicentre randomised controlled trial (WHICH study)

    2021  Volume 9

    Abstract: Abstract Background Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with colorectal cancer. Warfarin, a type of anticoagulant, is widely used for the treatment and prevention of ... ...

    Abstract Abstract Background Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with colorectal cancer. Warfarin, a type of anticoagulant, is widely used for the treatment and prevention of thromboembolism; however, bleeding may increase with its administration after polypectomy. In recent times, a high incidence of bleeding after endoscopic polypectomy has been reported in patients receiving heparin bridge therapy. However, previous studies have not compared the bleeding rate after endoscopic colorectal polypectomy between patients who continued with anticoagulant therapy and those who received heparin bridge therapy. We hypothesised that endoscopic colorectal polypectomy under the novel treatment with continuous warfarin is not inferior to endoscopic colorectal polypectomy under standard treatment with heparin bridge therapy with respect to the rate of postoperative bleeding. This study aims to compare the efficacy of endoscopic colorectal polypectomy with continuous warfarin administration and endoscopic colorectal polypectomy with heparin bridge therapy with respect to the rate of postoperative bleeding. Methods We will conduct a prospective multicentre randomised controlled non-inferiority trial of two parallel groups. We will compare patients scheduled to undergo colorectal polypectomy under anticoagulant therapy with warfarin. There will be 2 groups, namely, a standard treatment group (heparin bridge therapy) and the experimental treatment group (continued anticoagulant therapy). The primary outcome measure is the rate of postoperative bleeding. On the contrary, the secondary outcomes include the rate of cumulative bleeding, rate of overt haemorrhage (that does not qualify for the definition of haemorrhage after endoscopic polypectomy), incidence of haemorrhage requiring haemostasis during endoscopic polypectomy, intraoperative bleeding during endoscopic colorectal polypectomy requiring angiography, abdominal surgery and/or blood transfusion, ...
    Keywords Colorectal polypectomy ; Anticoagulants ; Warfarin ; Heparin bridge ; Vitamin K antagonist ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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