Akash Jangan, Zahir Mughal, Ahmar Ahmad, Mark Simmons, A. Sheikh, Faraz Mughal
Allergic rhinitis is an inflammatory disorder affecting nasal mucosa in response to allergen exposure and is commonly assessed and managed in family medicine. In this article, we review new international guidelines on the diagnosis and management of allergic rhinitis and generate evidence‐informed recommendations for family medicine doctors.
{"title":"Assessment and management of allergic rhinitis: A review and evidence‐informed approach for family medicine","authors":"Akash Jangan, Zahir Mughal, Ahmar Ahmad, Mark Simmons, A. Sheikh, Faraz Mughal","doi":"10.1002/jgf2.720","DOIUrl":"https://doi.org/10.1002/jgf2.720","url":null,"abstract":"Allergic rhinitis is an inflammatory disorder affecting nasal mucosa in response to allergen exposure and is commonly assessed and managed in family medicine. In this article, we review new international guidelines on the diagnosis and management of allergic rhinitis and generate evidence‐informed recommendations for family medicine doctors.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141650383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takuya Omura, Akemi Inami, Takahiro Kamihara, Yuki Tsuboi, Shuji Kawashima, Ken Tanaka, T. Sugimoto, Takashi Sakurai, Haruhiko Tokuda
{"title":"Identification of atypical hypoglycemia via continuous glucose monitoring in a patient presenting with hot flashes","authors":"Takuya Omura, Akemi Inami, Takahiro Kamihara, Yuki Tsuboi, Shuji Kawashima, Ken Tanaka, T. Sugimoto, Takashi Sakurai, Haruhiko Tokuda","doi":"10.1002/jgf2.718","DOIUrl":"https://doi.org/10.1002/jgf2.718","url":null,"abstract":"","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The effect of neglecting imaging in aspiration pneumonia diagnosis is not well understood. In this study, the computed tomography images of 50 patients diagnosed with aspiration pneumonia were retrospectively analyzed by three radiologists at a different hospital. Among these cases, 32%–42% were not classified as aspiration pneumonia based on imaging. Thus, imaging features may not have been adequately considered for diagnosing aspiration pneumonia. Although not all patients with aspiration pneumonia can be diagnosed based on imaging, aspiration pneumonia should be considered in the diagnosis as cases that are clearly nonaspiration pneumonia can be misdiagnosed as aspiration pneumonia.
{"title":"Computed tomography findings of 50 patients diagnosed with aspiration pneumonia: A case series","authors":"Akihito Ueda, Kanji Nohara, Nami Fujii, Kazuhiro Nakajima, Yumiko Miyauchi, Yutaka Inoue","doi":"10.1002/jgf2.717","DOIUrl":"https://doi.org/10.1002/jgf2.717","url":null,"abstract":"The effect of neglecting imaging in aspiration pneumonia diagnosis is not well understood. In this study, the computed tomography images of 50 patients diagnosed with aspiration pneumonia were retrospectively analyzed by three radiologists at a different hospital. Among these cases, 32%–42% were not classified as aspiration pneumonia based on imaging. Thus, imaging features may not have been adequately considered for diagnosing aspiration pneumonia. Although not all patients with aspiration pneumonia can be diagnosed based on imaging, aspiration pneumonia should be considered in the diagnosis as cases that are clearly nonaspiration pneumonia can be misdiagnosed as aspiration pneumonia.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141665366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.21203/rs.3.rs-3963516/v1
T. Tsuchida, Masanori Hirose, Hirotoshi Fujii, Ryunosuke Hisatomi, K. Ishizuka, Y. Inoue, K. Katayama, Y. Nakagama, Yasutoshi Kido, Takahide Matsuda, Yoshiyuki Ohira
Evidence for the pathogenesis and treatment of postacute coronavirus disease 2019 (COVID‐19) (long COVID) is lacking. As long COVID symptoms are predicted to have an impact on the global economy, clarification of the pathogenesis is urgently needed. Our experiences indicated that some symptoms were complicated by diseases established before the COVID‐19 pandemic.Using a retrospective, cross‐sectional study, we aimed to evaluate the diseases complicating long COVID. Using the medical records of patients with confirmed COVID‐19 exhibiting residual symptoms lasting ≥60 days postinfection who visited our clinic in January 2021–February 2023, we investigated the symptoms and diseases observed. We identified diseases that occurred after COVID‐19 and excluded those that were exacerbations of existing diseases.During the first visit, the most common symptoms reported in a total of 798 patients were fatigue (523 patients), anxiety (349 patients), and lack of motivation (344 patients). Complicating diseases were observed in 452 patients (57%). There were 115, 65, and 60 patients with postural tachycardia syndrome, postural syndrome without tachycardia, and mood disorders, respectively. Some diseases requiring immediate treatment included pulmonary thromboembolism, purulent shoulder arthritis, cerebellopontine angle tumors, myasthenia gravis, and cervical myelopathy.Not all symptoms that occur after COVID‐19 should be treated as long COVID. Similar to normal medical treatment, a list of differential diagnoses should be maintained based on symptoms to obtain definitive diagnoses.
{"title":"Evaluation of diseases complicating long COVID: A retrospective chart review","authors":"T. Tsuchida, Masanori Hirose, Hirotoshi Fujii, Ryunosuke Hisatomi, K. Ishizuka, Y. Inoue, K. Katayama, Y. Nakagama, Yasutoshi Kido, Takahide Matsuda, Yoshiyuki Ohira","doi":"10.21203/rs.3.rs-3963516/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-3963516/v1","url":null,"abstract":"Evidence for the pathogenesis and treatment of postacute coronavirus disease 2019 (COVID‐19) (long COVID) is lacking. As long COVID symptoms are predicted to have an impact on the global economy, clarification of the pathogenesis is urgently needed. Our experiences indicated that some symptoms were complicated by diseases established before the COVID‐19 pandemic.Using a retrospective, cross‐sectional study, we aimed to evaluate the diseases complicating long COVID. Using the medical records of patients with confirmed COVID‐19 exhibiting residual symptoms lasting ≥60 days postinfection who visited our clinic in January 2021–February 2023, we investigated the symptoms and diseases observed. We identified diseases that occurred after COVID‐19 and excluded those that were exacerbations of existing diseases.During the first visit, the most common symptoms reported in a total of 798 patients were fatigue (523 patients), anxiety (349 patients), and lack of motivation (344 patients). Complicating diseases were observed in 452 patients (57%). There were 115, 65, and 60 patients with postural tachycardia syndrome, postural syndrome without tachycardia, and mood disorders, respectively. Some diseases requiring immediate treatment included pulmonary thromboembolism, purulent shoulder arthritis, cerebellopontine angle tumors, myasthenia gravis, and cervical myelopathy.Not all symptoms that occur after COVID‐19 should be treated as long COVID. Similar to normal medical treatment, a list of differential diagnoses should be maintained based on symptoms to obtain definitive diagnoses.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 24‐year‐old female nurse with a 4‐month history of low back pain (LBP) was treated with acupuncture because of difficulty to her working. At the first presentation, the numerical rating scale (NRS) value was 7. After 2 weeks, the NRS value improved to 2–3, and she could bend over better, including when working night shifts. After 4 months, the NRS value remained at 1–2 so her relocating or leaving of absence from the ICU department was avoided. Acupuncture treatment for medical staff with LBP could relieve their pain and improve decreased clinical performance in hospitals or clinics.
{"title":"Significance of acupuncture treatment for medical staff with low back pain: A case report","authors":"Takuya Masuda, Kenichiro Egawa, Yu Takeshita, Koitchiro Tanaka","doi":"10.1002/jgf2.719","DOIUrl":"https://doi.org/10.1002/jgf2.719","url":null,"abstract":"A 24‐year‐old female nurse with a 4‐month history of low back pain (LBP) was treated with acupuncture because of difficulty to her working. At the first presentation, the numerical rating scale (NRS) value was 7. After 2 weeks, the NRS value improved to 2–3, and she could bend over better, including when working night shifts. After 4 months, the NRS value remained at 1–2 so her relocating or leaving of absence from the ICU department was avoided. Acupuncture treatment for medical staff with LBP could relieve their pain and improve decreased clinical performance in hospitals or clinics.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141666933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Here we report a case of primary adenocarcinoma of the upper jejunum, for which an early diagnosis could be made by computed tomography.
在此，我们报告了一例空肠上段原发性腺癌病例，计算机断层扫描可对其做出早期诊断。
{"title":"Primary adenocarcinoma of the upper jejunum","authors":"Yuichi Sanada MD, PhD","doi":"10.1002/jgf2.695","DOIUrl":"10.1002/jgf2.695","url":null,"abstract":"<p>Here we report a case of primary adenocarcinoma of the upper jejunum, for which an early diagnosis could be made by computed tomography.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141674388","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}
Japan is experiencing unprecedented decreasing birthrates. This preliminary study aimed to identify the municipalities in Aomori Prefecture that are successfully tacking declining birthrates using the Rurality Index for Japan (RIJ).We obtained 100‐level RIJ and census data from 1980 to 2020 for children (age < 15 years) in the municipal population of Aomori Prefecture.The analysis revealed generally weak but significant relationships between population variables and the RIJ.The RIJ is effective for identifying good practice communities that have developed and implemented solutions to prevent declining birthrates at the community level.
{"title":"Utility of the rurality index for Japan for exploring good practice solutions for declining birthrates in rural areas","authors":"O. Nomura, Yuki Soma, M. Kaneko","doi":"10.1002/jgf2.714","DOIUrl":"https://doi.org/10.1002/jgf2.714","url":null,"abstract":"Japan is experiencing unprecedented decreasing birthrates. This preliminary study aimed to identify the municipalities in Aomori Prefecture that are successfully tacking declining birthrates using the Rurality Index for Japan (RIJ).We obtained 100‐level RIJ and census data from 1980 to 2020 for children (age < 15 years) in the municipal population of Aomori Prefecture.The analysis revealed generally weak but significant relationships between population variables and the RIJ.The RIJ is effective for identifying good practice communities that have developed and implemented solutions to prevent declining birthrates at the community level.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anterior cutaneous nerve entrapment syndrome (ACNES) is the most common cause of abdominal wall pain. This study aimed to clarify the proportion of ACNES cases among those of abdominal pain and the clinical characteristics and prognosis of the disease in an emergency department (ED) of a Japanese general hospital.The medical records of patients from January 2014 to December 2023 were reviewed, and patients aged 15 years or older with abdominal pain with positivity for Carnett's sign, a good response to trigger point injection (TPI), and an ACNES diagnosis were included. The proportion of ACNES cases among the complaints related to abdominal pain in the ED between 2020 and 2023 was then determined. The recurrence rate was also determined using data from the medical records and telephone follow‐ups.Twenty‐one patients were included. Their median age was 50 years (range: 16–83 years), 13 (62%) were female, and 11 (52%) had acute‐onset pain. Follow‐up data were available for 11 patients (52%), seven (64%) of whom had recurrent pain for a median period of 1 week after the index visit. The proportion of ACNES cases among those of abdominal pain was 0.11%.ACNES might be uncommon among patients with abdominal pain in the ED setting although underdiagnosis of this condition might have led to an underestimation of the proportion of cases. Moreover, given the high recurrence rate of abdominal pain associated with ACNES, following up these patients is very important.
{"title":"A cross‐sectional study of anterior cutaneous nerve entrapment syndrome at a Japanese emergency department","authors":"Yasuhiro Kano, Junpei Komagamine, Kengo Murata","doi":"10.1002/jgf2.715","DOIUrl":"https://doi.org/10.1002/jgf2.715","url":null,"abstract":"Anterior cutaneous nerve entrapment syndrome (ACNES) is the most common cause of abdominal wall pain. This study aimed to clarify the proportion of ACNES cases among those of abdominal pain and the clinical characteristics and prognosis of the disease in an emergency department (ED) of a Japanese general hospital.The medical records of patients from January 2014 to December 2023 were reviewed, and patients aged 15 years or older with abdominal pain with positivity for Carnett's sign, a good response to trigger point injection (TPI), and an ACNES diagnosis were included. The proportion of ACNES cases among the complaints related to abdominal pain in the ED between 2020 and 2023 was then determined. The recurrence rate was also determined using data from the medical records and telephone follow‐ups.Twenty‐one patients were included. Their median age was 50 years (range: 16–83 years), 13 (62%) were female, and 11 (52%) had acute‐onset pain. Follow‐up data were available for 11 patients (52%), seven (64%) of whom had recurrent pain for a median period of 1 week after the index visit. The proportion of ACNES cases among those of abdominal pain was 0.11%.ACNES might be uncommon among patients with abdominal pain in the ED setting although underdiagnosis of this condition might have led to an underestimation of the proportion of cases. Moreover, given the high recurrence rate of abdominal pain associated with ACNES, following up these patients is very important.","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
(A) Gastroscopy showing multiple geographic erosions with white plaques from the angulus to the antrum. (B) Immunohistochemical staining for Treponema pallidum following gastric biopsy showing an abundance of brown syphilis spirochetes.
{"title":"An unusual cause of epigastric pain: Gastric syphilis","authors":"Naoya Itoh MD, DTM & H, PhD, Shun Iida MD, PhD, Masahiro Tajika MD, PhD","doi":"10.1002/jgf2.712","DOIUrl":"https://doi.org/10.1002/jgf2.712","url":null,"abstract":"<p>(A) Gastroscopy showing multiple geographic erosions with white plaques from the angulus to the antrum. (B) Immunohistochemical staining for <i>Treponema pallidum</i> following gastric biopsy showing an abundance of brown syphilis spirochetes.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.712","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152365","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}
Physical activity inequalities are an important global concern; nonetheless, few studies have comprehensively examined the association between physical activity inequalities and related factors. We aimed to explore factors associated with regional inequalities in physical activity in Japan.
Methods
We investigated the relationship of individual, psychological/behavioral, social, and built-environmental factors with the proportion of individuals with exercise habits across Japanese prefectures. We sourced data from open databases, including the Japanese National Health Insurance Claims and Nationwide Screening Program Database. We defined exercise habits as engaging in at least 30 min of moderate exercise at least twice a week. We employed multiple regression analysis to identify factors associated with prefectural level physical activity.
Results
The median proportion of individuals with exercise habits was 27% (interquartile range, 25–29). Higher frequency of exercise habits was associated with higher frequency of history of exercise (coefficients, 0.60; 95% confidence interval, 0.41–0.80) and lower proportion of female gender (coefficients, −1.74; 95% confidence interval, −2.80 to −0.69).
Conclusions
Exercise history and female gender may be related to prefectural level physical activity in Japan. Physical activity interventions should be promoted among women without exercise history.
{"title":"Factors associated with prefectural level physical activity in Japan: An ecological study","authors":"Noboru Horinouchi MD, MPH, Yuki Kataoka MD, MPH, DrPH, Kyoko Yamamoto MD, PhD, Seiji Shiota MD, PhD, Eishi Miyazaki MD, PhD","doi":"10.1002/jgf2.707","DOIUrl":"https://doi.org/10.1002/jgf2.707","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physical activity inequalities are an important global concern; nonetheless, few studies have comprehensively examined the association between physical activity inequalities and related factors. We aimed to explore factors associated with regional inequalities in physical activity in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated the relationship of individual, psychological/behavioral, social, and built-environmental factors with the proportion of individuals with exercise habits across Japanese prefectures. We sourced data from open databases, including the Japanese National Health Insurance Claims and Nationwide Screening Program Database. We defined exercise habits as engaging in at least 30 min of moderate exercise at least twice a week. We employed multiple regression analysis to identify factors associated with prefectural level physical activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median proportion of individuals with exercise habits was 27% (interquartile range, 25–29). Higher frequency of exercise habits was associated with higher frequency of history of exercise (coefficients, 0.60; 95% confidence interval, 0.41–0.80) and lower proportion of female gender (coefficients, −1.74; 95% confidence interval, −2.80 to −0.69).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Exercise history and female gender may be related to prefectural level physical activity in Japan. Physical activity interventions should be promoted among women without exercise history.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152286","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}
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