Internal medicine
-
The Importance of Stabilizing PaCO2 during Long-term Non-invasive Ventilation in Subjects with COPD.
In subjects with chronic obstructive pulmonary disease (COPD), the effect of partial pressure of CO2 (PaCO2) alterations during long-term non-invasive ventilation (NIV) on continuance remains uncertain. We herein investigated the utility of PaCO2 stability during long-term NIV as a prognostic outcome. ⋯ A lower 6 m-PaCO2 and a lower annual alteration of PaCO2 during long-term NIV are significant predictive variables for patients with COPD.
-
A lower frequency for the peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) Ser482 allele has been reported in elite-level endurance athletes among Caucasians, although this gene polymorphism has not been found to be associated with aerobic capacity in German, Dutch or Chinese populations. The purpose of the current study was to examine the associations between the Gly482Ser polymorphism and aerobic fitness in 112 Japanese middle-aged men. ⋯ The current results suggest that the PPARGC1A Ser482 allele is associated with a higher aerobic capacity in Japanese middle-aged men.
-
Insulin degludec (IDeg), a new long-acting basal insulin, and FlexTouch, a new injection device, recently became available in Japan. The efficacy and usefulness of IDeg and FlexTouch, compared with insulin glargine or detemir, were assessed in patients with type 2 diabetes mellitus. ⋯ Replacing basal insulin with IDeg is useful for the stable and accurate control of blood glucose levels in type 2 diabetes for those receiving a higher dose of basal insulin. Furthermore, the patients with a shorter duration of diabetes and a single insulin injection preferred FlexTouch.
-
A 52-year-old woman with ulcerative colitis was admitted to our hospital for an ulcerative colitis flare-up under salazosulfapyridine therapy. The symptoms improved with high-dose corticosteroids. After prednisolone was tapered to 10 mg, the frequency of diarrhea increased. ⋯ The patient was started on adalimumab. A positive response to the adalimumab therapy was observed after 2 weeks, during which time the ulcerative skin lesion healed completely, however, colonic mucosal healing was achieved at 2 months. Therefore, adalimumab appears to be an effective therapeutic option for patients with ulcerative colitis-associated pyoderma gangrenosum.
-
Case Reports
Dramatic Improvement of Diabetes Mellitus Following the Treatment of Coexisting Acromegaly and Cushing's Syndrome.
Endocrine diseases are frequently accompanied by diabetes mellitus and treatment of an underlying endocrine disease often improves glucose control. The co-occurrence of acromegaly and Cushing's syndrome is extremely rare. We herein describe a patient who showed a dramatic improvement in glucose control following treatment for co-existing acromegaly and Cushing's syndrome. ⋯ Her blood glucose was poorly controlled despite receiving high-dose insulin therapy. After undergoing adrenalectomy for Cushing's syndrome, her insulin dosage was decreased by almost 50%. The insulin treatment was discontinued following the treatment of acromegaly.