Internal medicine
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We herein report a 49-year-old Japanese man with relapsing polychondritis (RP) and aseptic meningoencephalitis. Four years ago, the patient was diagnosed with RP. Prednisolone (PSL) was started at 30 mg/day, and the symptoms promptly disappeared. ⋯ Intravenous cyclophosphamide was combined with PSL. After treatment, the patient's cognitive impairment clearly improved. In conclusion, RP rarely causes aseptic meningoencephalitis, highlighting the need for prompt and aggressive immunosuppressive therapy.
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Case Reports
Fulminant Myocarditis and Acute Appendicitis after COVID-19 Vaccination: A Case Report.
A 19-year-old Japanese man was hospitalized for cardiogenic shock 28 days after receiving a second dose of the coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine. He had had a high fever for three days with vomiting and abdominal pain before arriving at our hospital. ⋯ Thereafter, Impella CP left ventricular assist device implantation and venoarterial peripheral extracorporeal membranous oxygenation were initiated immediately along with inotropic support and steroid pulse therapy. Given these findings, he was finally diagnosed with multiple inflammatory syndrome and fulminant myocarditis.
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Objective In the Japanese Community-Based Integrated Care System (CBICS), access to formal care services is based on voluntary consultations mainly from the families of people with dementia (PWD). The problem is that some people need services but do not consult their municipalities for various reasons. The purpose of this study is to examine the possibility of using health insurance claims data to identify and characterize these PWD. ⋯ As a result, seven of these PWD started using long-term care insurance services or dementia prevention services. Conclusion PWD not accessing the CBICS can be identified using health insurance claims data. The results proved that the municipality has a cost-effective way of providing their services to PWD and their families, even if they have never consulted voluntarily.
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Actual Telemedicine Needs of Japanese Patients with Neurological Disorders in the COVID-19 Pandemic.
Objective During the coronavirus disease 2019 (COVID-19) pandemic, many social activities have moved online using applications for digital devices (e.g. computers, smartphones). We investigated the needs of telemedicine and trends in medical status and social care situations of Japanese patients with neurological disorders in order to estimate their affinity for an online telemedicine application. Methods We designed an original questionnaire for the present study that asked participants what problems they had with hospital visits, how the COVID-19 pandemic had affected their lives, and whether or not they would like to receive telemedicine. ⋯ Patients with headaches (60.0%) and epilepsy (38.1%) were more likely to want to use telemedicine than patients with PD (17.8%) or stroke (19.0%). Almost 90% of patients had access to a digital device, and there was no association between favoring telemedicine, ownership of a digital device, hospital visiting time, or waiting time at the hospital, although age was associated with motivation to telemedicine use (52.6 vs. 62.2 years old, p<0.001). Conclusion We can contribute to the management of the COVID-19 pandemic and the medical economy by promoting telemedicine, especially for young patients with headaches or epilepsy.