Internal medicine
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Review Case Reports
Flank pain, nausea, vomiting and hypotension in a chronic hemodialysis patient with a spontaneous perirenal hemorrhage.
Decreases in blood pressure develop in response to a wide range of clinical disorders. Various factors have been implicated in the development of hemodialysis-associated hypotension, including an impairment of the compensatory processes, an autonomic dysfunction or cardiac failure. ⋯ We herein report our experience with a chronic hemodialysis patient who developed severe hypotension with acute flank pain due to spontaneous bleeding around the kidney. Concerns regarding the management of the disease are also discussed.
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To evaluate the association between vitamin D receptor (VDR) BsmI gene polymorphism and the risk of end-stage renal disease (ESRD). ⋯ VDR BsmI gene polymorphism appears to not be associated with the risk of ESRD in the overall population, Caucasians or Asians. However, more studies should be performed in the future.
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Review Case Reports
Japanese features of native valve endocarditis caused by coagulase-negative staphylococci: case reports and a literature review.
Although coagulase-negative staphylococci (CoNS) is a frequent cause of prosthetic valve endocarditis, native valve endocarditis (NVE) caused by CoNS is not commonly seen. Its high mortality is well known; however, there are no systematic reports published in Japan. We herein report the cases of two Japanese patients with CoNS NVE who were admitted to our hospital located in Tokyo and conduct literature searches on CoNS NVE in Japan from 1983 to March 2012 using PubMed and ICHUSHI WEB (Japan Medical Abstract Society). We also summarize the features of 22 Japanese patients with CoNS NVE, including our patients.
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Multicenter Study
Is proton pump inhibitor therapy for reflux esophagitis sufficient?: a large real-world survey of Japanese patients.
Proton pump inhibitors (PPIs) are widely used as the mainstay of treatment for erosive reflux esophagitis, based on the excellent results obtained in clinical trials. However, the endoscopic remission rates in patients treated with PPIs in actual clinical settings have not been fully assessed. We conducted a nationwide survey to evaluate the effectiveness of PPIs based on endoscopic findings in real-world clinical settings. ⋯ This study revealed that approximately 40% of the patients did not achieve remission of erosive esophagitis following PPI therapy for a mean of 1.1 years. This suggests the necessity of providing careful follow-up using periodic endoscopy and appropriately selecting PPI therapy.
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The present study was undertaken to establish a useful range for the B-type natriuretic peptide (BNP) level, with the ultimate goal of determining a cut-off BNP level that will make it possible to identify patients with clinically important organic heart disorders among patients encountered in clinical practice. ⋯ These findings suggest that the lower range of the BNP level allowing for identification of patients with clinically important organic heart disorders increases with age; however, it might be appropriate to adopt a level of approximately 40 pg/mL, even in elderly patients, in order to avoid any possible age-related effects of diastolic dysfunction or other factors.