Internal medicine
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A 64-year-old man with autosomal dominant polycystic kidney disease (ADPKD) on hemodialysis presented with multiple lung masses. A computed tomography (CT)-guided biopsy revealed non-small-cell lung cancer (NSCLC). A cavitary mass in the right lung indicated primary NSCLC (cT2N1M1a, stage IVA). ⋯ On day 10 post-treatment, he developed acute respiratory failure with diffuse ground-glass opacities on chest CT, indicative of pembrolizumab-induced lung injury. Despite steroid pulse therapy, the patient died on day 13. An autopsy revealed left renal pelvic cancer with lung metastases, highlighting the diagnostic challenges in ADPKD.
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Objective To calculate the prevalence of anemia based on sex and age using large-scale occupational health examination data, confirm the Hb) distribution in the elderly, and examine the standard for screening for anemia in Japan. Methods Using existing large-scale occupational health examination data of patients who underwent health examinations between April 2015 and March 2022, we calculated the prevalence of anemia based on sex and age. Patients We included 416,366 patients aged 20-89 years who underwent health checkups at health checkup facilities in Japan. ⋯ Furthermore, the mean -2SD of Hb in the elderly men (>65 years) was 12.0 g/dL, larger than the current standard (11.0 g/dL). Conclusion It is imperative to consider the possibility of anemia in young women during health examinations and other screening opportunities, regardless of their history of anemia. In addition, elderly men with Hb levels <12 g/dL should be cautioned about the development of anemic symptoms and the progression of Hb decline.
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We herein report a case of concurrent immune thrombocytopenia (ITP) and ulcerative colitis (UC) that achieved remission following mesalazine treatment. A 16-year-old girl presented with severe thrombocytopenia, abdominal pain, and bloody stool. ⋯ Treatment with mesalazine promptly induced the remission of both ITP and UC, which was sustained. We reviewed 24 previously documented cases in which the simultaneous flares of UC and ITP were successfully managed.
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Objective Obstructive Sleep Apnea Syndrome (OSAS) causes multiple breathing interruptions during sleep and increases mortality if left untreated. Continuous positive airway pressure (CPAP) therapy improves the prognosis of OSAS; however, patient adherence is often poor. This study investigated the relationship between monthly hospital visits and CPAP adherence to CPAP therapy in patients with OSAS. ⋯ Conclusion The timing of monthly clinic visits significantly affected CPAP adherence, with late-month visits associated with poorer adherence. Visit frequency showed no clear correlation with adherence, suggesting that other factors may have influenced CPAP use. Further supportive interventions can enhance adherence and improve the treatment outcomes.
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A 40-year-old Japanese man with human immunodeficiency virus presented with disturbance of consciousness 2 years after dropping out. He was emaciated without any zoster skin lesions, and his CD4+ lymphocyte count was 4 cells/μL. ⋯ Antiretroviral therapy and intravenous acyclovir were administered, and the patient survived with neurological sequelae. VZV encephalitis is rare, particularly among people with AIDS, but it is a significant disease with a poor prognosis.