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The effect of prophylactic clipping for colorectal cold snare polypectomy (CSP) on delayed bleeding (DB) in patients with antithrombotic drugs remains unverified. The aim of the PERCOLD study is to demonstrate the non-inferiority of DB rates in cases without prophylactic clips compared with cases with prophylactic clips in patients taking antithrombotic drugs for colorectal CSP through randomised controlled trial (RCT).
This study is a multicentre prospective parallel-group RCT phase 3 trial that is being conducted at 14 institutions in Japan at the time of writing this manuscript. After providing consent, patients will undergo screening and assessment for study enrolment eligibility. Patients taking antithrombotic drugs (aged 20 years or older at the time of consent and who have agreed to participate in this study) will be selected if they have a preoperative suspected adenoma (including sessile serrated lesion) with an endoscopic diameter of
The trial protocol has been approved by the Chiba University Certified Clinical Research Reviewer Board (CRB3180015), which serves as the central ethics committee, and registered with Japan Registry of Clinical Trials. The current protocol V.1.7, dated 4 October 2024. Written informed consent for participation in the study will be obtained from all participating patients. All participating institutions have formally agreed to conduct the study in accordance with this central approval, and local site permissions were obtained as required by each institution. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences.
Japan Registry of Clinical Trials (jRCT1032230086).
by Keiko Tanaka, Keisuke Nishijima, Ken’ichi Furuya, Satoko Shin, Michiaki Kai
The global prevalence of end-stage kidney failure is increasing, with hemodialysis as the primary treatment. An arteriovenous fistula serves as a critical lifeline for patients undergoing hemodialysis, yet its function often deteriorates due to complications such as narrowing or blockage of the blood vessels. This study aimed to clarify the relationships between the sound properties of blood flow through arteriovenous fistulas and a medical/surgical history of patients undergoing hemodialysis by analyzing the distribution of sound frequencies from 100 to 4,000 Hz. Data were collected from 53 patients to identify two key parameters: the time point within one cycle of arteriovenous fistula sounds where the power distribution reached its peak, expressed as a percentage, and the specific frequency where the power was highest within the analyzed range. The results showed that well-functioning arteriovenous fistulas exhibited peak power within the first 25 percent of the sound cycle and the highest power at 200 Hz. In contrast, higher peak percentages and lower power at 200 Hz were associated with surgical interventions due to complications such as narrowing or blockage of the arteriovenous fistula. These findings suggest that the sound properties of arteriovenous fistulas, combined with patient-specific characteristics, may serve as non-invasive indicators of arteriovenous fistula function and help predict the risk of complications. This approach provides valuable insights for improving the management of arteriovenous fistulas and patient outcomes in hemodialysis therapy.by Haruhiko Hoshino, Mitsuki Ikeda, Yujiro Matsuishi, Yuki Enomoto, Nobutake Shimojo, Misaki Kotani, Shunsuke Kobayashi, Takahiro Kido, Satomi Hayashi, Yoko Furuya, Yoshiaki Inoue
IntroductionIn some regions, critically ill pediatric and adult patients are cared for in the same intensive care unit, complicating pain assessment due to mixed age groups. To address this, it is essential to use pain scales that are applicable to a wide age range. The Critical-Care Pain Observation Tool (CPOT) was developed to assess pain in both intubated and non-intubated adult patients. However, its applicability in pediatric patients has not been confirmed. The purpose of this study was to evaluate CPOT for critically ill pediatric patients.
MethodsWe conducted a prospective observational study in an eight-bed open PICU from January 2022 to March 2023. Three research nurses independently assessed pain using CPOT, the Face, Legs, Activity, Cry, Consolability (FLACC) scale, and an Observational Visual Analog Scale (VAS obs). Criterion-related and construct validity were examined using Spearman’s rank correlation coefficients between CPOT, VAS obs, and FLACC. Diagnostic performance was evaluated via ROC analysis using a FLACC score ≥ 4 as the reference. CPOT scores with and without medical interventions were compared using the Mann–Whitney U test, and inter-rater reliability was assessed with Cohen’s weighted κ.
ResultsNinety-one patients were observed 165 times. CPOT strongly correlated with VAS obs (Spearman’s ρ = 0.87, p Conclusions
This study suggests that CPOT may be a useful tool for pain assessment in pediatric patients.
FreshRSS 