Objectives: Clinical evidence on prophylactic antibiotics for transarterial chemoembolization (TACE) to prevent liver abscess is limited because liver abscess is a rare event. This study aimed to analyse the association between prophylactic antibiotic use for TACE and the occurrence of liver abscess after TACE. Methods: Using the nationwide Diagnosis Procedure Combination database in Japan, we retrospectively identified patients who underwent TACE for hepatic cancer between July 2010 and March 2017. The primary outcome was liver abscess requiring procedural intervention within 30 days of TACE. Secondary outcomes included 30-day in-hospital mortality and length of stay. Propensity score matching was performed to adjust for potential confounding factors and compare outcomes between patients with and without prophylactic antibiotics. Results: Among 167 544 eligible patients, 134 712 received antibiotics and 32 832 did not. In the matched cohort of 29 211 pairs, the proportion of patients with liver abscess requiring procedural intervention was significantly lower in the antibiotics group than in the no-antibiotics group (0.08% vs. 0.22%, p 0.001; relative risk (95% confidence interval), 0.35 (0.22e0.57); absolute risk reduction, 0.0014 (0.0008 e0.0021); and number needed to treat, 696 (476e1223)). There was no significant difference in 30-day in-hospital mortality between the groups. The length of stay was longer in the antibiotics group than in the no-antibiotics group (median, 10 vs. 9 days, p < 0.001). Conclusions: Prophylactic antibiotic use in patients undergoing TACE was associated with a reduced occurrence of liver abscess requiring procedural intervention.

Propensity score analysis suggested no significant association between the choice of anesthetic maintenance agent and the occurrence of suspected early-onset periprosthetic joint infection in patients undergoing total knee arthroplasty.

The propensity-matched analyses revealed that the use of sivelestat was not associated with decreased mortality for pneumonia patients requiring mechanical ventilation.

Objectives Hereditary angioedema (HAE) is a rare disease with acute attacks in the skin and mucosa throughout the body including life‐threatening laryngeal edema and abdominal attacks with severe pain. Physicians, regardless of specialty, may encounter HAE patients in their daily practice; however, low disease awareness may attribute to a considerable number of undiagnosed HAE patients in Japan. This study aims to identify issues associated with the diagnosis processes of HAE and to determine levels of HAE awareness among Japanese physicians from various specialties. Methods A web‐based quantitative survey was conducted using a physicians panel. Physicians from the following departments were included in the survey: internal medicine, dermatology, pediatrics, emergency medicine, and gastroenterological surgery. Results The proportions of physicians in dermatology, pediatrics, emergency medicine, internal medicine, and gastroenterological surgery who were able to select the C1‐INH activity test as a diagnosis test for potential HAE patients were 71.8%, 59.7%, 57.1%, 40.3%, and 25.7%, respectively. Multivariate analysis showed significant association between physicians who selected “strongly suspected” AE based on the case‐scenario and physicians who had knowledge of the essential HAE symptoms (laryngeal edema, swelling after tooth extraction, swelling of the tongue, and abdominal pain). Conclusions This study showed that disease awareness of HAE varied among medical specialties, suggesting the importance of educational activities in academic societies and specialist accreditation in raising HAE awareness. Proper knowledge of complement testing and HAE symptoms may help not only to diagnose patients with AE‐like symptoms as AE but also to differentially diagnose HAE from AE.