Medical Journal Club with Dr. Takuji Shirasawa

Takuji Shirasawa, MD
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This Channel Presents the Update of Medical Journal on Regenerative Medicine, AntiAging Medicine, and Longevity Medicine.

  1. Alcohol-related liver disease

    4d ago

    Alcohol-related liver disease

    Alcohol-related liver disease (ALD) is a prevalent global health issue, contributing to significant mortality and encompassing a spectrum of liver damage from steatosis to decompensated cirrhosis and hepatocellular carcinoma. This review summarizes the current state of ALD, emphasizing both early and advanced stages, including alcohol-related hepatitis (AH). The epidemiology, diagnostic tools, natural history, and key progression factors of ALD are discussed, highlighting the role of diagnostic tools and pathways in early and advanced stages of ALD. The review also addresses the importance and particularities of the treatment of alcohol use disorder in patients with ALD, covering both psychological and pharmaceutical interventions. Finally, treatments for ALD-related fibrosis and AH are discussed, presenting both the currently available and future treatment options. The conclusions of this review underscore the need for comprehensive strategies to improve diagnosis, prognostic stratification, and treatment strategies at all stages of ALD.

    22 min
  2. Sjögren’s Syndrome with Polyserositis, Gastrointestinal Findings and Ascending Aortic Aneurysm

    5d ago

    Sjögren’s Syndrome with Polyserositis, Gastrointestinal Findings and Ascending Aortic Aneurysm

    Sjögren’s syndrome (SS) is an autoimmune disease with glandular and extraglandular manifestations. Pleural and pericardial effusions in association with SS are rare. Similarly, ascites is rare and it can occur in SS when combined with primary biliary cirrhosis (PBC). Inflammatory Abdominal Aortic Aneurysm together with SS has been described only in one case. We report herein the case of a 70-year-old man with SS presenting with polyserositis (pleural and pericardial effusion and ascites) and gastrointestinal manifestations (atrophic gastritis and candida esophagitis) and ascending aorta aneurysm. SS was diagnosed based on xerophthalmia, xerostomia, extraglandular manifestations, positive results for the Schirmer test, ocular surface staining score, histopathologic examination of labial buccal mucosa revealing focal lymphocytic sialadenitis and unstimulated salivary flow rate. The only positive autoantibody was against smooth muscle cells (ASMA). We thought that pleural, pericardial effusions, ascites, gastrointestinal findings and ascending aortic aneurysm may be related with autoimmunological inflammation of SS. To evaluate the extent of aortic vasculitis, we performed a whole body 18-Fluorodeoxyglucosepositron emission tomography (FDG-PET) and showed increased uptake of FDG in aneurysmal section of the ascending aorta. Treatment with high dose corticosteroid was proved to be successful in both clinically and laboratory.

    15 min
  3. Long‑term clinical course and outcome in patients with primary Sjögren syndrome‑associated interstitial lung disease

    Jun 12

    Long‑term clinical course and outcome in patients with primary Sjögren syndrome‑associated interstitial lung disease

    Interstitial lung disease (ILD) is the most common lung manifestation in patients with Sjögren syndrome (SJS) and is associated with poor outcomes. This study aimed to investigate the longterm clinical course and prognostic factors in patients with SJS-ILD. Clinical data and high-resolution computed tomography (HRCT) images of 62 patients with primary SJS-ILD were retrospectively analyzed (biopsy-proven cases, n = 16). The mean patient age was 59.8 years; 83.9% of the patients were females, and 38.7% showed a usual interstitial pneumonia (UIP) pattern on HRCT. The median follow-up period was 61.5 months. During follow-up, 15 patients (24.2%) died, 7 (11.3%) experienced acute exacerbation (AE), and 27 (43.5%) progressed. The 1-, 3- and 5-year survival rates were 93.5%, 85.8%, and 81.1%, respectively. Age (hazard ratio [HR]: 1.158, P = 0.003), C-reactive protein (CRP) level (HR: 1.212, P = 0.045), FVC (HR: 0.902, P = 0.005), and a UIP pattern on HRCT (HR: 4.580, P = 0.029) were significant prognostic factors in multivariable Cox analysis. In conclusion, death, AE, and ILD progression occurred in 25%, 10%, and 50% of the patients with SJS-ILD, respectively. Older age, higher CRP level, lower FVC, and a UIP pattern on HRCT indicated poor prognosis. Primary Sj.gren syndrome (SJS) is a chronic systemic inflammatory disorder characterized by impaired

    21 min
  4. Potential Roles in Vascular Repair, Endothelial Recovery, and Thromboinflammatory Modulation

    Jun 10

    Potential Roles in Vascular Repair, Endothelial Recovery, and Thromboinflammatory Modulation

    The CORAGENmay be understood as a complex biological preparation enriched withregenerative growth factors (GFs), cytokines (CKs), extracellularvesicles/exosomes, and regulatory microRNAs (miRs) that collectivelyexert cardiovascular, endothelial, anti-inflammatory, reparative, andpotentially indirect antithrombotic effects.

    22 min
  5. The role of B cells in Sj¨ogren's syndrome and their impact on the nervous system

    Jun 9

    The role of B cells in Sj¨ogren's syndrome and their impact on the nervous system

    Primary Sj¨ogren's syndrome is an autoimmune disease characterized by the dryness of exocrine glands. Recent studies emphasizes the significant role of B cells in its pathogenesis. This review provides an overview of the functions of B cells in Sj¨ogren's syndrome and their impact on the nervous system. Current studies on the association between B cell-mediated immune responses and neurological symptoms are reviewed, aiming to offer new insights for diagnosing and treating. Understanding these connections is crucial for addressing the complex interplay between the immune system and neurological manifestations in affected individuals. A critical gap remains in determining whether B cell dysregulation initiates neuropathology or amplifies pre-existing neural inflammation, highlighting the need for mechanistic studies to guide targeted therapies.

    24 min

  6. Jun 5

    Glucocorticoid drivwn neural Rewiring

    Glucocorticoid drivwn neural Rewiring

    17 min

  7. Jun 5

    Glucocorticoid driven Neural Rewiring

    Glucocorticoid driven Neural Rewiring

    20 min
  8. School Refusal

    May 26

    School Refusal

    Considering the problems associated with school attendance, school refusal is an adjustment problem that tends to become increasingly prevalent. The present study identifies the patterns reported in the literature on school refusal and outlines the structure and sub-components of school refusal. Therefore, the systematic review method was selected as the research method for this study. The data sources of this study consist of 40 research articles that fell within the purview of WoS and were either included or excluded according to predetermined inclusion and exclusion criteria. Using MAXQDA 2020, both content and descriptive analyses were conducted in synthesizing the data sources. As a result of the analysis, the study year, method, data collection tool, data collection procedure, data analysis, and sample were examined as descriptive characteristics. Analyzing the content characteristics, five themes were identified: risk factors for school refusal, school refusal symptoms, school refusal protective factors, approaches, and techniques for intervention in school refusal, and consequences of school refusal. The findings are provided by discussing the related literature

    52 min
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