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Evaluation of diseases complicating long COVID: A retrospective chart review 评估长COVID并发症:回顾性病历审查
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-08 DOI: 10.1002/jgf2.716
Tomoya Tsuchida MD, PhD, Masanori Hirose MD, PhD, Hirotoshi Fujii MD, Ryunosuke Hisatomi MD, Kosuke Ishizuka MD, PhD, Yoko Inoue MD, Kohta Katayama MD, PhD, Yu Nakagama MD, PhD, Yasutoshi Kido MD, PhD, Takahide Matsuda MD, PhD, Yoshiyuki Ohira MD, PhD

Background

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.

Methods

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.

Results

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.

Conclusion

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.

背景 2019 年急性冠状病毒病(COVID-19)(长 COVID)的发病机制和治疗方法尚缺乏证据。由于预计长COVID症状将对全球经济产生影响,因此迫切需要明确其发病机制。我们的经验表明,一些症状是由 COVID-19 大流行之前就已存在的疾病并发的。 方法 我们采用回顾性横断面研究,旨在评估长期 COVID 的并发症。我们利用 2021 年 1 月至 2023 年 2 月期间在本诊所就诊的确诊 COVID-19 患者的病历,对感染后症状持续≥60 天的残留症状和疾病进行了调查。我们确定了在 COVID-19 之后发生的疾病,并排除了那些原有疾病加重的疾病。 结果 在首次就诊的 798 名患者中,最常见的症状是疲劳(523 人)、焦虑(349 人)和缺乏动力(344 人)。452名患者(57%)出现并发症。患有体位性心动过速综合征、无心动过速的体位性综合征和情绪障碍的患者分别为 115 人、65 人和 60 人。一些需要立即治疗的疾病包括肺血栓栓塞、化脓性肩关节炎、小脑脑角肿瘤、重症肌无力和颈椎病。 结论 并非 COVID-19 后出现的所有症状都应作为长 COVID 治疗。与普通治疗类似,应根据症状列出鉴别诊断清单,以获得明确诊断。
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引用次数: 0
Significance of acupuncture treatment for medical staff with low back pain: A case report 针灸治疗医务人员腰痛的意义:病例报告
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-08 DOI: 10.1002/jgf2.719
Takuya Masuda MD, Kenichiro Egawa MD, Yu Takeshita LAc, Koitchiro Tanaka MD

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.

一名 24 岁的女护士有 4 个月的腰背痛病史,因工作困难而接受针灸治疗。首次就诊时,她的数字评定量表(NRS)值为 7。两周后,NRS 值改善为 2-3,她可以更好地弯腰,包括在上夜班时。4 个月后,NRS 值仍为 1-2,因此避免了她搬迁或离开重症监护室部门。针灸治疗腰椎间盘突出症可以缓解医务人员的疼痛,改善他们在医院或诊所的临床表现。
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引用次数: 0
Primary adenocarcinoma of the upper jejunum 空肠上段原发性腺癌
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-05 DOI: 10.1002/jgf2.695
Yuichi Sanada MD, PhD

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。
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引用次数: 0
Utility of the rurality index for Japan for exploring good practice solutions for declining birthrates in rural areas 日本乡村指数在探索解决农村地区出生率下降问题的良好做法方面的效用
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-04 DOI: 10.1002/jgf2.714
Osamu Nomura MD, MA, PhD, Yuki Soma PhD, Makoto Kaneko MD, MSc, PhD

Background

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).

Methods

We obtained 100-level RIJ and census data from 1980 to 2020 for children (age < 15 years) in the municipal population of Aomori Prefecture.

Results

The analysis revealed generally weak but significant relationships between population variables and the RIJ.

Conclusions

The RIJ is effective for identifying good practice communities that have developed and implemented solutions to prevent declining birthrates at the community level.

日本正在经历前所未有的出生率下降。这项初步研究旨在利用日本乡村指数(RIJ),找出青森县成功应对出生率下降的市镇。我们获得了青森县市镇人口中儿童(年龄小于 15 岁)的 1980 年至 2020 年 100 级 RIJ 和人口普查数据,分析结果显示,人口变量与 RIJ 之间的关系一般较弱,但很显著。
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引用次数: 0
A cross-sectional study of anterior cutaneous nerve entrapment syndrome at a Japanese emergency department 日本急诊科前皮神经卡压综合征横断面研究
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-03 DOI: 10.1002/jgf2.715
Yasuhiro Kano MD, Junpei Komagamine MD, Kengo Murata MD, PhD

Background

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.

Methods

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.

Results

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%.

Conclusion

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.

前皮神经卡压综合征(ACNES)是导致腹壁疼痛的最常见原因。本研究旨在明确日本一家综合医院急诊科(ED)中ACNES病例在腹痛病例中所占的比例,以及该病的临床特征和预后。研究人员回顾了2014年1月至2023年12月期间患者的病历,纳入了15岁或15岁以上腹痛且卡奈特征阳性、对扳机点注射(TPI)反应良好并确诊为ACNES的患者。然后确定了 2020 年至 2023 年期间急诊室腹痛相关主诉中 ACNES 病例的比例。此外,还通过病历数据和电话随访确定了复发率。21名患者的中位年龄为50岁(16-83岁),13名(62%)为女性,11名(52%)为急性腹痛。11名患者(52%)获得了随访数据,其中7名患者(64%)在就诊后1周内反复出现疼痛。ACNES在急诊室腹痛患者中所占的比例为0.11%。在急诊室腹痛患者中,ACNES可能并不常见,但对该病症的诊断不足可能会导致低估病例比例。此外,鉴于与 ACNES 相关的腹痛复发率较高,对这些患者进行随访非常重要。
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引用次数: 0
An unusual cause of epigastric pain: Gastric syphilis 上腹痛的一个不寻常原因:胃梅毒
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-24 DOI: 10.1002/jgf2.712
Naoya Itoh MD, DTM & H, PhD, Shun Iida MD, PhD, Masahiro Tajika MD, PhD

(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.

(A) 胃镜检查显示从胃角到胃窦有多处带白色斑块的地域性糜烂。(B) 胃活检后对苍白螺旋体进行免疫组化染色,显示大量棕色梅毒螺旋体。
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引用次数: 0
Factors associated with prefectural level physical activity in Japan: An ecological study 日本县级体育活动的相关因素:生态研究
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-19 DOI: 10.1002/jgf2.707
Noboru Horinouchi MD, MPH, Yuki Kataoka MD, MPH, DrPH, Kyoko Yamamoto MD, PhD, Seiji Shiota MD, PhD, Eishi Miyazaki MD, PhD

Background

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.

背景 身体活动不平等是全球关注的一个重要问题;然而,很少有研究全面考察了身体活动不平等与相关因素之间的联系。我们旨在探究与日本地区体育活动不平等相关的因素。 方法 我们调查了个人、心理/行为、社会和建筑环境因素与日本各都道府县有锻炼习惯的个人比例之间的关系。我们从公开数据库(包括日本国民健康保险索赔数据库和全国筛查项目数据库)中获取数据。我们将运动习惯定义为每周至少两次、每次至少 30 分钟的中等强度运动。我们采用多元回归分析来确定与都道府县体育锻炼水平相关的因素。 结果 有运动习惯的人数比例中位数为 27%(四分位数间距为 25-29)。较高的运动习惯频率与较高的运动史频率(系数,0.60;95% 置信区间,0.41-0.80)和较低的女性比例(系数,-1.74;95% 置信区间,-2.80 至-0.69)相关。 结论 在日本,运动史和女性性别可能与都道府县的体育锻炼水平有关。应在无运动史的女性中推广体育锻炼干预措施。
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引用次数: 0
Recurrent pulmonary embolism complicated with myotonic dystrophy type 1 复发性肺栓塞并发 1 型肌营养不良症
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-14 DOI: 10.1002/jgf2.709
Hiraku Sedogawa MD, Masahiro Yabe MD, Keiichi Tsuchida MD, Yasuo Hirose MD

Myotonic dystrophy is a hereditary neurological disease. While cardiovascular complications have been recognized, recent reports indicate that it increases the risk of deep vein thrombosis and pulmonary embolism (DVT/PE) compared to other dystrophies and healthy individuals with dyspraxia and a history of DVT as risk factors. It is important to consider myotonic dystrophy in patients with repeated idiopathic DVT/PE and to provide appropriate medical consultation.

肌营养不良症是一种遗传性神经系统疾病。虽然心血管并发症已得到公认,但最近的报告显示,与其他肌营养不良症和健康人相比,肌营养不良症增加了深静脉血栓形成和肺栓塞(DVT/PE)的风险,而运动障碍和深静脉血栓形成史是风险因素。对于反复出现特发性深静脉血栓/肺栓塞的患者,考虑肌营养不良症并提供适当的医疗咨询非常重要。
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引用次数: 0
Point-of-care ultrasound for Lemierre's syndrome during the COVID-19 pandemic: A case report 在 COVID-19 大流行期间对莱米尔综合征进行护理点超声检查:病例报告
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-14 DOI: 10.1002/jgf2.708
Yosuke Kawai MD, Kei Nishiyama MD, PhD

Lemierre's syndrome is a fatal condition characterized by septic thrombophlebitis of the internal jugular vein (IJV). Early diagnosis of Lemierre's syndrome in primary care remains challenging because of its rarity and common initial symptoms like fever and sore throat. The COVID-19 pandemic has increased the difficulty of diagnosis, along with many diagnostic delays. Herein, we report a case in which an IJV thrombus was detected using point-of-care ultrasound (POCUS), leading to the diagnosis of Lemierre's syndrome. During the COVID-19 pandemic, POCUS was a simple and noninvasive technique for screening Lemierre's syndrome without radiation and low droplet exposure.

勒米尔综合征是一种以颈内静脉(IJV)化脓性血栓性静脉炎为特征的致命疾病。由于其罕见性以及发热和咽喉痛等常见的初期症状,在初级保健中早期诊断勒米尔氏综合征仍具有挑战性。COVID-19 大流行增加了诊断难度,同时也造成了许多诊断延误。在本文中,我们报告了一例使用床旁超声(POCUS)检测到 IJV 血栓并最终确诊为 Lemierre 综合征的病例。在 COVID-19 大流行期间,POCUS 是一种简单、无创的莱米尔综合征筛查技术,没有辐射,飞沫暴露量低。
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引用次数: 0
Practice locations of physicians with highly educated spouses in Japan: A cross-sectional study using National Census Data 日本高学历配偶医生的执业地点:利用全国人口普查数据进行的横断面研究
IF 1.8 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-14 DOI: 10.1002/jgf2.710
Atsushi Miyawaki MD, PhD, Jun Tomio MD, PhD

Background

Having highly educated spouses may influence physicians' choice of practice location.

Methods

We analyzed a representative physician sample in the 2020 Japan Population Census.

Results

Regression analyses adjusting for physicians' characteristics showed that physicians married to highly educated (with a graduate degree) spouses were less likely to practice in low physician supply areas (LPSAs) than other married physicians (adjusted, 7.8% vs. 9.1%; adjusted odds ratio, 0.84; 95% CI, 0.72–0.98).

Conclusion

Having highly educated spouses was associated with a lower likelihood of practicing in LPSAs. Qualitative research is needed to explore how spousal academic attainment influences physicians' practice location choices.

我们分析了 2020 年日本人口普查中具有代表性的医生样本。调整了医生特征的回归分析表明,与其他已婚医生相比,配偶受过高等教育(拥有研究生学位)的医生在低医生供应区(LPSAs)执业的可能性较低(调整后,7.8% vs. 9.1%;调整后的几率比,0.84;95% CI,0.72-0.98)。需要进行定性研究来探讨配偶的学历如何影响医生的执业地点选择。
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引用次数: 0
期刊
Journal of General and Family Medicine
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