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27 results on '"Takeuchi, Masato"'

26. Clinical Outcomes of Acute Appendicitis During Pregnancy: Conservative Management and Appendectomy.

Author

Nakashima M, Takeuchi M, and Kawakami K

Subjects
Appendectomy, Conservative Treatment, Female, Humans, Japan, Length of Stay, Postoperative Complications, Pregnancy, Retrospective Studies, Appendicitis diagnostic imaging, Appendicitis epidemiology, Appendicitis surgery, Laparoscopy
Abstract

Purpose: We have described the epidemiology, diagnostic modality, treatment patterns, and outcomes of acute appendicitis during pregnancy., Methods: Using a nationwide claim-based database in Japan, we analyzed the data of pregnant patients who were diagnosed with appendicitis between January 2005 and May 2019. Patient characteristics, imaging studies, length of hospital stay, proportion of fetal losses, complications, and type of antibiotics were examined., Results: The study included 169 patients, of whom 113 patients (67%) underwent conservative management, and appendectomies were performed on 56 patients (open 25% and laparoscopic 8%). The proportion of ultrasonography, computed tomography, and magnetic resonance imaging were 97%, 17%, and 5% (for conservative management); 88%, 39%, and 13% (for appendectomy); 86%, 38%, and 21% (for open appendectomy); and 93%, 43%, and 14% (for laparoscopic appendectomy), respectively. The proportion of complicated appendicitis was 6% in conservative management and 41% in appendectomy (40% in open appendectomy and 43% in laparoscopic appendectomy), respectively. The incidence of fetal loss was 4% in conservative management, 5% in appendectomy (2% in open appendectomy, and 14% in laparoscopic appendectomy). However, there was only one fetal loss (in laparoscopic appendectomy) in the same case of hospitalization. There were no maternal deaths or serious complications after any treatment., Conclusion: All treatments showed acceptable outcomes in appendicitis during pregnancy. Conservative management is considered an acceptable option, especially in uncomplicated cases of appendicitis in pregnant women.

Published
2021
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27. Population-based incidence of diabetic ketoacidosis in type 2 diabetes: medical claims data analysis in Japan.

Author

Takeuchi M, Kawamura T, Sato I, and Kawakami K

Subjects
Adult, Aged, Diabetes Mellitus, Type 2 drug therapy, Diabetic Ketoacidosis etiology, Female, Follow-Up Studies, Hospitalization statistics & numerical data, Humans, Hypoglycemic Agents therapeutic use, Incidence, Japan epidemiology, Male, Middle Aged, Diabetes Mellitus, Type 2 complications, Diabetic Ketoacidosis epidemiology, Insurance Claim Review statistics & numerical data
Abstract

Purpose: Determination of the incidence rate of diabetic ketoacidosis (DKA) in type 2 diabetes mellitus (T2DM) is urgent, in response to the safety issue with use of the glucose lowering drugs, sodium-glucose cotransporter-2 inhibitors, and DKA., Methods: We extracted data of adult patients with T2DM from a medical claims database in Japan, which included 1 million individuals. The study period was 2005-2013, before the era of sodium-glucose cotransporter-2 inhibitors. The inclusion criteria were patients with a diagnosis of T2DM who had at least 1 prescription for a glucose-lowering drug. We further examined the number of DKA-related admissions and medication use prior to admission. Calculation of DKA incidence was on a patient-years basis, with 95% confidence interval using a Poisson distribution., Results: Of 36,674 adult patients with T2DM, we identified 74 cases admitted for DKA, with an estimated DKA incidence of 0.48/1000 (95% confidence interval, 0.38-0.60/1000) patient-years. Of these 74 cases, approximately two-thirds of patients had no past or recent history of glucose-lowering drug use before admission for DKA., Conclusions: This study estimated that the incidence of DKA was 0.48/1000 patient-years in Japan, similar to previous studies. We also found that underuse of glucose-lowering medication was common among patients hospitalized for DKA. KEY POINTS The population-based incidence of DKA in T2DM is largely unknown. In Japan, the estimated DKA incidence was 0.48/1000 (95% CI, 0.38-0.60/1000) patient-years. Drug-induced DKA is an emerging research area, and our results can be applied to evaluating the risk of DKA., (Copyright © 2017 John Wiley & Sons, Ltd.)

Published
2018
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