Author: Nakamura, Masanao ; Osawa, Satoshi ; Sawada, Ryoichi ; Hosoe, Naoki ; Baba, Yukiko ; Ohmiya, Naoki ; Hotta, Naoki ; Tanaka, Shinji ; Togashi, Kazutomo ; Ikebuchi, Yuichiro ; Oka, Shiro ; Hiraga, Hiroto ; Matsumoto, Hiroshi ; Mukai, Rieko ; Furuta, Takahisa ; Mitsufuji, Shoji ; Kawano, Seiji ; Sasaki, Yu ; Tajiri, Hisao ; Kobayashi, Taku ; Nonogaki, Koji ; Shimada, Masaaki ; Nouda, Sadaharu ; Nakaji, Konosuke ; Katsuki, Shinichi ; Omori, Takafumi

BACKGROUND AND AIMSWe determined the factors influencing total capsule colonoscopy, adequate cleansing, and detectability of second-generation colon capsule endoscopy (CCE) for colorectal polyps or tumors (CRTs), adverse events, and acceptability.METHODSAmong 44 Japanese hospitals, 1006 patients with suspected or documented colorectal diseases who underwent CCE were enrolled prospectively.RESULTSThe total capsule colonoscopy rate was 86.1%. Age younger than 63 years (adjusted odds ratio [aOR], 1.525), male sex (aOR, 1.496), inflammatory bowel disease (aOR, 1.889), lavage intake on day -1 (aOR, 1.625), ≥1800-mL lavage intake on day 0 (aOR, .595), prokinetics on day 0 (aOR, .608), and ≥30-mL castor oil booster on day 0 (aOR, 1.734) were significant independent predictors. The overall adequate cleansing rate was 65.5%. Constipation (aOR, .527), lavage intake on day -1 (aOR, 1.822), laxative intake on day -1 (aOR, 2.616), and ≥1900-mL lavage intake on day 0 (aOR, 1.449) were significant independent predictors. The detection rates for patients with CRTs ≥6 mm and ≥10 mm were 92% (95% confidence interval, 84-97) and 89% (95% confidence interval, 78-96), respectively. Inadequate cleansing in the ascending colon (aOR, .184), ≥6-mm CRT in the transverse colon (aOR, 4.703), and ≥6-mm CRT in the left-sided colon (aOR, 32.013) were significant independent predictors. CCE retention occurred in 2 patients (.20%) requiring endoscopic and surgical interventions. In total, 63% of patients desired CCE for their next colonoscopy.CONCLUSIONSCCE was relatively safe, well tolerated, and useful for detecting colorectal lesions when adequate bowel preparation was made. (Clinical trial registration number: UMIN000021936.).

01 Feb 2025·The Journal of Arthroplasty

Preoperative Abnormal Posture Improves After Total Knee Arthroplasty: Knee–Hip–Spine Syndrome

Article

Author: Kajikawa, Yoshiteru ; Yotsumoto, Tadahiko ; Watanabe, Nobuyoshi ; Oshima, Yasushi ; Takeoka, Toru ; Majima, Tokifumi

BACKGROUNDSpinal, pelvic, and lower extremity alignment is crucial for maintaining a healthy body posture. However, with aging, this posture becomes challenging to maintain due to muscle weakness and skeletal degeneration. Osteoarthritis (OA) of the hip and knee can also lead to abnormal posture, known as hip-spine and knee-spine syndrome. Total knee arthroplasty (TKA) can help relieve pain and improve lower extremity alignment. This may also improve abnormal posture, such as in knee-hip-spine syndrome. However, the condition of the contralateral knee may affect this improvement. This study evaluated the effects of TKA on clinical outcomes and radiographic body posture.METHODSPatients scheduled for primary one-sided TKA were divided into 2 groups: the unilateral group comprised patients who had contralateral knee OA conditions. The bilateral group included patients who had prior contralateral TKA. Knee range of motion, the Knee Injury and Osteoarthritis Outcome Score, radiographic lateral femorotibial angle, hip and knee flexion angles, and sagittal vertical axis while standing were measured 24 months after TKA.RESULTSBoth groups showed improved knee extension, the Knee Injury and Osteoarthritis Outcome Score, and radiographical femorotibial angle and hip and knee flexion angles 24 months after TKA. The sagittal vertical axis also improved 6 months after TKA in both groups and was maintained in the bilateral group, while it deteriorated again in the unilateral group 24 months after TKA.CONCLUSIONSA TKA can improve abnormal body posture due to knee OA as in knee-hip-spine syndrome. However, the condition of a contralateral knee can affect TKA outcomes.LEVEL OF EVIDENCELevel III; prospective case-control study.

01 Oct 2024·Endoscopy International Open

Additional 30-second observation of the right-sided colon for missed polyp detection with linked color imaging compared with narrow band imaging

Article

Author: Murakami, Takaaki ; Itoh, Yoshito ; Inada, Yutaka ; Tomita, Yuri ; Yoshida, Naohisa ; Tomie, Akira ; Fukumoto, Kohei ; Hirose, Ryohei ; Okuda, Kotaro ; Morimoto, Yasutaka ; Kobayashi, Reo ; Dohi, Osamu ; Hashimoto, Hikaru ; Yasuda, Ritsu ; Inagaki, Yoshikazu ; Hasegawa, Daisuke ; Inoue, Ken

Abstract Background and study aims We previously demonstrated the efficacy of an additional-30-seconds (Add-30s) observation with linked color imaging (LCI) or narrow band imaging (NBI) of the cecum and ascending colon (right-sided colon) after white light imaging (WLI) observation for improving adenoma detection rate (ADR) by 3% to 10%. We herein compared Add-30s LCI with Add-30s NBI in a large number of cases. Patients and methods We retrospectively collected 1023 and 1011 cases with Add-30s LCI and NBI observation for right-sided colon in 11 affiliated institutions from 2018 to 2022 and propensity score matching was performed. Add-30s observation was as follows. First observation: WLI observation of the right-sided colon as first observation. Second observation: Reobservation of right-sided colon by Add-30s LCI or NBI. The comparison of the mean numbers of adenoma+sessile serrated lesions (SSLs) and adenomas per patient (MASP and MUTYH-associated polyposis) were analyzed in the Add-30s LCI/NBI groups. The increase in right-sided ADR was also analyzed in the groups. Results Among 748 matched cases in the Add-30s LCI/NBI groups, the MASP and MAP were 0.18/0.19 (P = 0.54) and 0.14/0.15 (P = 0.70). Among experts, they were 0.17/0.22 (P = 0.16) and 0.15/0.21 (P = 0.08). Among non-experts, they were 0.13/0.12 (P = 0.71) and 0.12/0.07 (P = 0.04). The right-sided ADRs of the first+second observations in the LCI and NBI groups were 32.2% and 28.9% (P = 0.16) and the increase of ADRs were 7.5% and 7.2% (P = 0.84). Conclusions In right-sided colon, the detection of adenoma/SSL did not differ between Add-30s LCI and NBI. Both of them significantly increased ADR.

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