Ethnic comparison in takotsubo syndrome : novel insights from the International Takotsubo Registry

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers.Open Access funding provided by Universität Zürich. CT has been supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Programme and the Swiss Heart Foundation. L.S.M. has been supported by EU HORIZON 2020 (SILICOFCM ID777204). J.R.G has received a grant “Filling the gap” from the University of Zurich. The InterTAK Registry is supported by The Biss Davies Charitable Trust.info:eu-repo/semantics/publishedVersio

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes.Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients.Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 +/- 11.4 years vs. 68.0 +/- 12.0 years; p Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers.</p

A case of robot‐assisted laparoscopic partial nephrectomy during pregnancy

Introduction Malignancy during pregnancy requires consideration of both the mother and fetus. We report a patient with renal cell carcinoma during pregnancy who was treated with robot‐assisted partial nephrectomy. Case presentation The patient was incidentally found to have a renal mass on abdominal ultrasonography. Definitive diagnosis of cT1aN0M0 RCC was made by enhanced computed tomography. Subsequently, pregnancy was discovered. RAPN was performed without complications. Pathologic examination revealed clear cell RCC. There were no postoperative complications, and the baby was born safely. Conclusion RAPN can be safe and effective even during pregnancy. Every pregnant patient requires individualized treatment involving the timing of surgery, the procedure used, and management based on the condition of the mother and fetus, tumor stage, and the experience of the surgical team

A case of abiraterone acetate withdrawal syndrome after initiation of upfront abiraterone therapy for high‐risk prostate cancer

Introduction Transient decrease in serum prostate‐specific antigen level can occur after abiraterone acetate withdrawal in male patient with metastatic castration‐resistant prostate cancer. Here, we report a case of abiraterone acetate withdrawal syndrome with transient prostate‐specific antigen decrease after progression to castration‐resistant disease while using upfront abiraterone therapy for high‐risk prostate cancer. Case presentation A 73‐year‐old man with hormone‐sensitive high‐risk prostate cancer with multiple bone metastases (prostate‐specific antigen level, 294.109 ng/mL) received upfront abiraterone/prednisolone combination and androgen deprivation therapy. One year later, prostate‐specific antigen level decreased to 0.017 ng/mL (nadir) but it gradually rose by 15 months after treatment initiation. He was diagnosed as castration‐resistant and new bone metastases appeared. After abiraterone was discontinued, prostate‐specific antigen level decreased and stabilized at a low level for 5 months. Conclusion Abiraterone acetate withdrawal syndrome was observed when hormone‐sensitive prostate cancer with upfront abiraterone therapy progressed to castration‐resistant prostate cancer

Enrichment of the Fundamentals for Nature Educations in Remote Islands and Places in Okinawa Prefecture4 Flora and noteworthy plants of Minna-jima Island, Motobu-cho, the Ryukyu Islands

Vascular flora of a small island Minna, situated 1.5 km northwest from Motobu peninsula of Okinawa Island, was studied to gain a basis for nature education in remote islands. 237 species of vascular plants of 68 families were found on the island in wild state. Among them Atriplex maximowicziana, Cardamine impatiens and Caesalpinia bonduc were mentioned as floristically noteworthy species in the flora of the island. Passiflora minima was noticed to spread over the floor and shrubs in Casuarina seaside woods

Primary renal peripheral T‐cell lymphoma, not otherwise specified, treated with partial nephrectomy

Introduction Renal involvement by non‐Hodgkin's lymphoma is very rare, and the kidney as the primary site of this lymphoma is much more uncommon. We report a case of primary renal peripheral T‐cell lymphoma, not otherwise specified, treated with partial nephrectomy. Case presentation A 63‐year‐old man was hospitalized with coronavirus infectious disease, emerged in 2019 in the emergency department. Computed tomography examination showed a 2‐cm renal mass in the right kidney. Abdominal enhanced computed tomography examination revealed that the noted mass showed good enhancement in the corticomedullary phase and washout in the nephrogenic phase. No metastatic lesions were found. He was diagnosed as having cT1aN0M0 renal cell carcinoma, and robotic‐assisted partial nephrectomy was carried out. The pathological diagnosis was peripheral T‐cell lymphoma, not otherwise specified. He has been followed for 20 months after robotic‐assisted partial nephrectomy without additional treatment and recurrence. Conclusion We experienced a primary renal peripheral T‐cell lymphoma, not otherwise specified that was followed up without treatment after surgery