Elevated blood pressure is frequently observed during cancer treatment with vascular endothelial growth factor inhibitors, reflecting either a treatment-emergent adverse event or pharmacological effect. Appropriate blood pressure management is critical in minimizing cardiovascular risk and prevent treatment interruption. Although home blood pressure monitoring is recommended to detect masked or white-coat hypertension, longitudinal data on home blood pressure trajectories during therapy remain limited. This multicenter observational pilot study aims to evaluate the association between clinic and home blood pressure in patients with malignant tumors receiving vascular endothelial growth factor inhibitors, and to assess factors associated with blood pressure variability and the feasibility of home monitoring during therapy. Approximately 50 participants are being enrolled. Home blood pressure is measured twice daily throughout the treatment period, and clinical, laboratory, and treatment-related data and patient-reported data are collected at baseline, during therapy, and at follow-up. The primary outcome is the difference between clinic and home blood pressures at multiple time points during and after vascular endothelial growth factor inhibitor therapy. Blood pressure phenotypes will be classified according to clinic and home blood pressure thresholds, and their clinical characteristics will be compared. Longitudinal trajectory of home blood pressure will be assessed to explore patterns associated with clinical outcomes. This study will clarify the relationship between clinic and home blood pressure, explore factors influencing blood pressure variability, and provide preliminary evidence on the feasibility and clinical value of home blood pressure monitoring in patients receiving angiogenesis inhibitor therapy.
BACKGROUND:Previous research on the relationship between alcohol and stroke has highlighted several issues. Notably, the conventional categorization based on average consumption, which categorizes both those who consume 20 g/day of alcohol daily and those who engage in risky single-occasion drinking (RSOD) only on weekends into low drinkers, makes it difficult to account for individuals who fall into distinct characteristics. This study examined the association between alcohol and stroke, accounting for both average drinking levels and RSOD occurrences. METHODS:In a community-based prospective cohort study in Japan, 8026 men and 12,461 women were followed from 1989 to 2018. The outcome was the first-ever stroke event during the follow-up period. Alcohol consumption was divided into seven categories: never drinkers; former drinkers; low drinkers (<20 g/day on average for men and <10 g/day for women) without RSOD; moderate drinkers (20-59 g/day on average for men and 10-39 g/day for women) without RSOD; low drinkers with RSOD; moderate drinkers with RSOD; and heavy drinkers (≥60 g/day on average for men and ≥40 g/day for women). RSOD was defined as consuming ≥60 g for men and ≥40 g for women on a single occasion. We calculated sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for stroke across these drinking categories compared with never drinkers. RESULTS:Low-to-moderate drinkers with RSOD experienced a significantly higher hazard of stroke; the multivariable HR (95% CI) of 1.47 (1.01-2.13) among men and 3.41 (1.50-7.79) among women. Overall, although some were not significant, low-to-moderate drinkers with and without RSOD tended to be associated with a higher hazard of stroke, except for low drinkers with RSOD in women. CONCLUSIONS:RSOD potentially increases the risk of stroke among men and women, even if their usual amount of alcohol consumption is low to moderate.
Bleeding after graft reperfusion is a significant challenge in pancreas transplantation (PTx). To reduce post-reperfusion bleeding, we developed a modified bench surgery technique, combining a vessel-sealing system (LigaSure™) with indigo carmine (IC) leak testing. This study evaluates the clinical efficacy and safety of this method. We reviewed, retrospectively, 54 consecutive PTx procedures, with (n = 25) or without (n = 29) the novel LigaSure™ plus IC (L + IC) method, performed between 2010 and 2024. Surgical outcomes, postoperative complications, graft loss, and glucose tolerance were compared between the control and L + IC groups. The safety of IC (9.0 µg/mL) for pancreatic islet cells was assessed through in vitro AO/PI staining and glucose-stimulated insulin secretion (GSIS) assays. The L + IC group showed significantly less post-reperfusion bleeding than the control group (715 mL vs. 360 mL; p = 0.0122). Multivariate analysis identified that L + IC was independently associated with reduced post-reperfusion bleeding (odds ratio 0.2171, p = 0.0171). IC exposure did not impair islet cell viability or function. The HbA1c and C-peptide levels were comparable between the groups. Our novel L + IC bench surgery technique proved safe and effective for reducing bleeding after pancreas graft reperfusion. Further prospective multicenter studies should be carried out to confirm its impact on long-term surgical outcomes.
Low intake of B vitamins may increase dementia; However, epidemiological evidence, particularly for riboflavin (vitamin B₂), remains sparse. This study aimed to examine the association between dietary intakes of B vitamins (riboflavin, vitamin B6, vitamin B12, and folate) and the incidence of disabling dementia necessitating care under Japan’s national insurance over a 15-year observation period. As part of the Circulatory Risk in Communities Study, a prospective study involving a community-based cohort of 4171 Japanese individuals aged 40–69 years was conducted. Dietary intakes of B vitamins were estimated through a single 24-h dietary recall method. Disabling dementia was defined by the daily living disability status related to dementia based on the long-term care insurance system of Japan. Hazard ratios of disabling dementia were estimated using area-stratified Cox proportional hazard models. Over a median follow-up of 15.4 years, 887 cases of disabling dementia were identified. Riboflavin intake was inversely associated with the risk of disabling dementia; the multivariable hazard ratio for the highest versus lowest quartiles was 0.51 (95
