Ichinomiya

Researchers are evaluating the effectiveness and safety of upadacitinib at different doses in adults with moderate to severe atopic dermatitis (AD) who have not responded adequately to dupilumab treatment. AD is a skin condition causing rash and itching due to inflammation, and some people require systemic treatments beyond topical therapies. This phase 3b/4 study aims to provide data on upadacitinib's impact on AD symptoms in this specific population. The study is conducted in two open-label periods. In Period 1, participants are randomly assigned to receive either upadacitinib 15mg orally once daily or dupilumab 300mg by subcutaneous injection every two weeks. After two weeks, those on upadacitinib 15mg may have their dose increased to 30mg based on their response. Period 2 lasts 24 weeks, during which participants either continue their assigned dose or switch doses depending on their eczema severity scores. The entire treatment duration is 32 weeks with follow-up for 30 days after treatment ends. Participants will undergo regular visits at hospitals or clinics for medical assessments, blood tests, side effect monitoring, and questionnaires to evaluate treatment effects. The main outcome measured is the number of participants achieving at least a 90% improvement in their eczema severity index by week 8. The study includes a 35-day screening period before treatment begins and monitors safety and efficacy throughout the study duration.

Researchers are comparing the effects of two types of nerve blocks, femoral triangle block (FTB) and adductor canal block (ACB), on early quadriceps muscle function after total knee arthroplasty (TKA). The main goal is to find out if FTB causes more early quadriceps impairment than ACB when used alongside a standardized multimodal pain relief protocol. The study involves adults undergoing primary unilateral TKA and focuses on early postoperative recovery. Participants are randomly assigned to receive either an ultrasound-guided FTB or ACB. Both groups also receive a popliteal plexus block to manage pain at the back of the knee. Specifically, 10 mL of 0.25% levobupivacaine is injected in the targeted nerve areas for each block, and 15 mL of the same anesthetic is used for the popliteal plexus block. These procedures are performed under ultrasound guidance to ensure accuracy and minimize motor involvement where possible. During the study, quadriceps function is assessed 6 hours after block completion by testing the ability to perform a straight leg raise and measuring muscle strength compared to preoperative baseline. Other outcomes include quadriceps function at 24 hours, pain levels, use of additional pain medication, early mobilization and rehabilitation progress, knee motion range, time to reach 120 degrees active knee flexion, and local anesthetic spread using ultrasound. This information helps evaluate the balance of motor impairment and pain control after surgery under the pain management protocol.

Researchers are evaluating the effectiveness and safety of a Double-effect kissing balloon technique (W-KBT) using Perfusion balloon (PB) and Drug coated balloon (DCB) in patients with left main coronary artery disease (LMD) who have left circumflex artery (LCx) ostium stenosis. This is a prospective, observational, multi-center study focusing on patients with stable angina, non-ST-elevation acute coronary syndrome, or unstable angina who are undergoing percutaneous coronary intervention (PCI). Patients who meet selection criteria will be enrolled and treated under usual care. The PCI procedure involves W-KBT following crossover stenting for the left main trunk to left anterior descending artery direction, proximal optimization technique (POT), and conventional kissing balloon technique (C-KBT) as the optimal treatment. Operators will obtain consent before performing PCI and will register cases continuously to assess the technique's efficacy and safety. Participants will undergo PCI with W-KBT, and data will be collected during the procedure to measure procedure success rates. Researchers will monitor major adverse cardiovascular events (MACE) within 12 months after PCI. The study will gather real-world data from multiple centers to evaluate the outcomes and safety of this treatment approach over time.