JMA journal最新文献_第8页

Bloody Diarrhea in a 27-year-old Man with Adult-onset Still's Disease. 一名患有成人型斯蒂尔病的 27 岁男子的血性腹泻。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0103

Ken Nagahata, Kazuyuki Murase, Masatoshi Kanda, Hiroki Takahashi

{"title":"Bloody Diarrhea in a 27-year-old Man with Adult-onset Still's Disease.","authors":"Ken Nagahata, Kazuyuki Murase, Masatoshi Kanda, Hiroki Takahashi","doi":"10.31662/jmaj.2023-0103","DOIUrl":"10.31662/jmaj.2023-0103","url":null,"abstract":"A 27-year-old man presented with quotidian fever, rash, knee arthralgia, sore throat, and bloody diarrhea. Laboratory findings showed neutrophilia, elevated CRP, ferritin, and liver enzyme levels, and decreased hemoglobin levels. Radiological investigations revealed splenomegaly, systemic lymphadenopathy, thickening of the descending colon wall, and an abnormal uptake in the bone marrow and spleen as seen in F-fluorodeoxyglucose positron emission tomography. Malignant lymphoma was initially suspected, but biopsies showed no malignant findings. Colonoscopy revealed mucosal friability, erosions, and shallow ulcers, and pathological findings included crypt abscesses suggestive of either acute infectious colitis or inflammatory bowel disease. The patient was eventually diagnosed with adult-onset Still's disease (AOSD) and started on prednisolone, which resolved bloody diarrhea, leading to the diagnosis of comorbid ulcerative colitis (UC). The combination of AOSD and UC presents a diagnostic challenge due to overlapping symptoms. An accurate diagnosis requires careful exclusion of other diseases and a comprehensive assessment.","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between Care-need Level after Discharge and Long-term Outcomes in 7491 Patients Requiring Rehabilitation for Stroke. 7491 名需要康复治疗的脑卒中患者出院后的护理需求水平与长期疗效之间的关系。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0094

Takaaki Konishi, Haruhi Inokuchi, Yusuke Sasabuchi, Hiroki Matsui, Masahiko Tanabe, Yasuyuki Seto, Hideo Yasunaga

{"title":"Association between Care-need Level after Discharge and Long-term Outcomes in 7491 Patients Requiring Rehabilitation for Stroke.","authors":"Takaaki Konishi, Haruhi Inokuchi, Yusuke Sasabuchi, Hiroki Matsui, Masahiko Tanabe, Yasuyuki Seto, Hideo Yasunaga","doi":"10.31662/jmaj.2023-0094","DOIUrl":"10.31662/jmaj.2023-0094","url":null,"abstract":"Introduction: Stroke is a major cause of disability and mortality worldwide and requires long-term care, including rehabilitation. This study aims to elucidate the association between care-need levels after discharge and long-term outcomes in patients with stroke.Methods: We used a Japanese administrative database that covers both medical and long-term care insurance systems to retrospectively identify 7491 patients who underwent acute-phase in-hospital rehabilitation for stroke between June 2014 and February 2019. We investigated the association between nationally standardized care-need levels (support levels 1-2 and care-need levels 1-3) 6 months after discharge and long-term outcomes. Using the Fine-Gray model, we conducted multivariable survival analysis with adjustment for patient backgrounds and treatment courses to estimate hazard ratios (HR) for mortality and the incidence of being bedridden.Results: The median age was 82 (interquartile range [IQR], 76-87) years, 5418 patients (72%) had cerebral infarction, and 4009 patients (54%) had partial dependence after discharge. During a median follow-up of 580 (IQR, 189-925) days, 1668 patients (22%) became bedridden, and 2174 patients (29%) died. Compared with patients with support level 1, those with higher care-need levels showed significantly higher proportions of being bedridden-the subdistribution HR [95% confidence interval] were 1.52 [1.10-2.12], 2.85 [2.09-3.88], and 3.79 [2.79-5.15] in those with care-need levels 1, 2, and 3, respectively. Higher care-need levels were also significantly associated with higher mortality.Conclusions: This large-scale observational study demonstrated that a higher level of care-need after discharge was significantly associated with poorer functional outcomes and higher mortality.","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous Writing, Reviewing, and Editing by Physicians. 由医生连续撰写、审阅和编辑。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0115

Soichiro Saeki

引用次数: 0

Response: Rectus Sheath Hematoma Can Resemble Bladder Hematoma on Ultrasound. 回应：直肠鞘血肿在超声波上可与膀胱血肿相似。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0140

Hiroshi Shiba, Tomomi Endo, Hirohisa Fujikawa, Tatsuo Tsukamoto

引用次数: 0

Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island. 2019 年冠状病毒疾病大流行对淡路岛医疗实践的影响。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0107

Yoshihiko Omori, Naoto Oka, Yasukuni Suzuki, Masayuki Shima, Hiroki Nishikawa, Kenzo Tsuzuki

{"title":"Impact of the Coronavirus Disease 2019 Pandemic on Medical Practices in Awaji Island.","authors":"Yoshihiko Omori, Naoto Oka, Yasukuni Suzuki, Masayuki Shima, Hiroki Nishikawa, Kenzo Tsuzuki","doi":"10.31662/jmaj.2023-0107","DOIUrl":"10.31662/jmaj.2023-0107","url":null,"abstract":"Introduction: Since the first confirmed case of coronavirus disease 2019 (COVID-19) in China, COVID-19 continues to be a global threat and exerts a significant impact on medical practices. This study aims to investigate the impact of the COVID-19 pandemic on medical practices in Awaji Island, a remote island in Japan.Methods: First, we conducted a survey on the epidemiological characteristics of COVID-19 on Awaji Island before and during the pandemic. Next, using a questionnaire, we conducted a survey with doctors working full time at Hyogo Prefectural Awaji Medical Center, which is the only designated infectious disease hospital on Awaji Island.Results: The COVID-19 infection rate of Awaji Island was lower than that of Hyogo Prefecture and of Japan as a whole, although the peaks occurred simultaneously. Outpatient visits as well as hospitalized patients, i.e., inpatients, decreased during the pandemic as a result of restrictions on surgeries and hospitalizations, with no changes in the disease composition ratio. The results of the questionnaire show that during the pandemic, doctors working full time at our hospital worked less and slept more. Furthermore, data obtained from the Medical Affairs Department showed a decrease in overtime hours worked and an increase in the number of days of paid holidays taken.Conclusions: Epidemiologically, the impact of the COVID-19 pandemic on Awaji Island showed a similar trend to that in Japan, but the results of the survey questionnaire indicated that doctors working full time at our hospital were not necessarily adversely affected.","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10834151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lesson Learned from Impact of COVID-19 Pandemic on People with Visual Impairment. 从 COVID-19 大流行对视障人士的影响中汲取教训。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-12-27 DOI: 10.31662/jmaj.2023-0193

Kimiko Ueda

引用次数: 0

Pseudobladder Sign: A Sign but Not Pseudosign. 假性膀胱征：是征而非假征。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0128

Steven H Yale, Halil Tekiner, Eileen S Yale

引用次数: 0

Use of Expired Drugs: Patients Benefits versus Industry Interest. 过期药品的使用：患者利益与企业利益。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2022-0209

Anis Arioua, David Shaw

引用次数: 0

Can the Care-need Level Determined by Local Certification Board Predict Long-term Clinical Outcomes in Patients with Stroke? 地方认证委员会确定的护理需求级别能否预测脑卒中患者的长期临床结果？

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-12-27 DOI: 10.31662/jmaj.2023-0182

Kenichi Sakakura

引用次数: 0

Changing Seasonality of Influenza in the Post-COVID Era in Japan. 后 COVID 时代日本流感季节性的变化。

JMA journal Pub Date : 2024-01-15 Epub Date: 2023-11-16 DOI: 10.31662/jmaj.2023-0150

Keita Wagatsuma, Teruhime Otoguro

引用次数: 0