Internal medicine
-
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.
-
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.
-
A 50-year-old man was diagnosed with type 1 autoimmune pancreatitis (AIP) following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and a histopathological examination. After six months of untreated follow-up, the serum IgG4 level decreased, and the diffuse pancreatic enlargement improved; however, a pancreatic head mass became apparent. ⋯ After pancreatoduodenectomy, AIP did not recur. The development of AIP in this case could be related to paraneoplastic syndrome.
-
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.
-
Objective Our previous study indicated that the efficacy of metformin in lowering glycated hemoglobin (HbA1c) levels may be influenced by the pretreatment frequency of defecation (FD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to further examine how FD and the metformin dose may affect HbA1c changes (ΔHbA1c) in T2DM patients. Methods A retrospective analysis was conducted on inpatients who received antidiabetic treatment without altering dosages for six months post-discharge, except for minor insulin adjustments. ⋯ A multiple regression analysis identified posttreatment FD and metformin dose as significant independent factors influencing ΔHbA1c levels. Additionally, diabetic peripheral neuropathy and diabetes duration were found to diminish the effectiveness of metformin, likely due to decreased posttreatment FD. Conclusion FD may independently contribute to the dose-dependent HbA1c-lowering effects of metformin.