Internal medicine
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Mucormycosis has emerged as the third-most common fungal mycosis and is one of the most fatal molds. We herein report a case study of a 30-year-old woman who was a veterinarian, specializing in livestock, who developed disseminated mucormycosis during induction therapy for acute lymphoblastic leukemia. ⋯ Reports of successful treatments are extremely rare, and our case has had the longest documented remission from disseminated disease. We speculate that our case's occupational environment may represent a risk factor for development of mucormycosis.
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Objective There is a paucity of information on whether the hepatitis B virus (HBV) vaccine, derived from HBV genotype C, can prevent mother-to-child transmission of HBV genotype D. The aim of this study was to clarify this issue. Methods The subjects consisted of 25 children (8.5±4.1 years old, 7 males, 18 females), born to 17 mothers who were chronically infected with HBV genotype D. ⋯ Anti-HBs were positive in 13 children and negative in 12. Conclusion All children born to mothers infected with genotype D, including 20 who were inoculated with the genotype C-derived vaccine, were negative for both HBsAg and anti-HBc. These results suggest that the genotype C-derived HB vaccine is effective in preventing mother-to-child transmission from mothers infected with HBV genotype D.
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Objective The measurement of C-peptide immunoreactivity (CPR) is essential for evaluating the pancreatic β-cell function and selecting appropriate therapeutic agents in patients with diabetes mellitus. The meal tolerance test (MTT) is simple to administer physiological insulin-stimulating test. Previous studies have reported that several CPR-related indices are useful markers for predicting insulin requirement in type 2 diabetes. ⋯ The serum CPR level at 120 minutes in the MTT was strongly correlated with the area under the curve of CPR during the MTT. The patients who needed insulin therapy at 6 months after hospitalization showed a significant lower incremental CPR value from 0 to 120 minutes in the MTT than those who did not need insulin therapy. Conclusion The plasma C-peptide levels at 0 and 120 minutes in the MTT provide essential information for the clinical management of patients with type 2 diabetes mellitus.
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Objective To evaluate the effect of endovascular therapy (EVT) on the central blood pressure (CBP) and augmentation index (AIx) in patients with peripheral artery disease (PAD). Methods The CBP and AIx were assessed by radial applanation tonometry the day before and the day after EVT. We compared the differences in the therapeutic effects between the stenotic and occlusive lesions and between the iliac and superficial femoral artery (SFA) lesions. ⋯ The effects of EVT on the CBP and AIx were equivalent, regardless of whether the target lesion was the stenotic lesion or the occlusive lesion. There were no significant differences between the iliac and SFA lesions in the effects of EVT on the CBP and AIx. Conclusion EVT improved the CBP and AIx in patients with PAD, regardless of the morphology or site of the lesions.
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Objective In primary percutaneous coronary intervention (PCI), the door-to-balloon time (DTBT) is known to be associated with in-hospital death in patients with ST-segment elevation myocardial infarction (STEMI). However, little is known regarding the association between the DTBT and the mid-term clinical outcomes in patients with STEMI. The purpose of this study was to investigate the association between the DTBT and mid-term all-cause death. ⋯ In the multivariate Cox regression analysis, although a short DTBT [vs. intermediate DTBT: hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.39-2.55, p=0.99] was not associated with all-cause death, a long DTBT (vs. intermediate DTBT: HR 2.80, 95% CI 1.26-6.17, p=0.011) was significantly associated with all-cause death, after controlling for confounding factors such as Killip class 4, an impaired renal function, and the number of diseased vessels. Conclusion The DTBT was significantly associated with the incidence of mid-term all-cause death. Our results support the strong adherence to the DTBT in patients with STEMI.