Internal medicine
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The aim of this study was to establish a causal relationship between excess body weight and the onset of diabetes in a retrospective cohort study. ⋯ Overweight/obesity (high BMI) is an independent and dose-dependent risk factor for type 2 diabetes in overweight Japanese patients. Our results confirmed the usefulness of BMI as a classic parameter, and the importance of lifestyle modification and better management among people with overweight/obesity for prevention of type 2 diabetes mellitus.
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We herein report a case of severe postsurgical hypocalcemia associated with primary hyperparathyroidism (pHPT), Graves' disease (GD) and acromegaly (AC). A 54-year-old woman was referred to our clinic for treatment of pHPT and GD. She also had active AC and was clinically diagnosed as multiple endocrine neoplasm type 1 because of pHPT and AC. ⋯ We performed total parathyroidectomy and thyroidectomy. After the operation, she showed severe hypocalcemia induced by postsurgical hypoparathyroidism and hungry bone syndrome. This is a rare case of postsurgical severe hypocalcemia associated with pHPT, GD and AC.
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The aim of this study is to propose the cutoff level of waist circumference (WC) on the basis of homeostasis model assessment of insulin resistance (HOMA-IR) levels in order to diagnose metabolic syndrome (MetS). ⋯ This study suggests that WC level should be more strictly managed than current criteria, for preventing the development of MetS in non-diabetic middle-aged Japanese men.
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We conducted a retrospective study assessing the relationship between comorbidity, using the Charlson Comorbidity Index (CCI), and the prognoses of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) patients. ⋯ This study showed that the prognosis of ALI and ARDS was affected more by comorbidity than by age, and that the CCI was useful for assessing patient comorbidities in ALI and ARDS. We have to consider that patients with a CCI score of 4 or more are at risk of developing multi-organ failure and have a poor prognosis.
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Case Reports
Case of type 1 diabetes mellitus following interferon β-1a treatment for multiple sclerosis.
A 57-year-old woman who had been treated with interferon β-1a (IFNβ-1a) for multiple sclerosis was diagnosed with diabetic ketosis. Her fasting serum C-peptide (F-CPR) was 1.9 ng/mL and her daily urinary C-peptide (U-CPR) was 24.1 µg/day. Her anti-glutamic acid decarboxylase (GAD) antibody was 3.5 U/mL. ⋯ Her F-CPR and U-CPR were very low (0.1 ng/mL and 8.35 µg/day, respectively), and anti-GAD antibody became distinctly positive (12.4 U/mL). She had HLA-DRB1*04:05, A24, and B54. For these reasons, IFNβ-1a administration was considered a possible cause of type 1 diabetes mellitus in this case.