We present a 23-year-old woman with depression and long COVID in whom a diagnosis of idiopathic ventricular tachycardia (VT) was made. Although the relationship between idiopathic VT and long COVID remains unknown, this is the first report of idiopathic VT detected in a patient with long COVID.
A 78-year-old woman visited the outpatient clinic with a 4-week history of low-grade fever of unknown origin. One week after fever onset, she visited the dental clinic because of upper left toothache and left jaw claudication, and she was scheduled to have a mouthpiece made. No dental caries was observed. Since the cause of fever was not clear, the patient visited our clinic. On presentation, she was alert, and her vital signs were normal. Physical examination revealed a slightly enlarged left temporal artery without pulsation and tenderness (Figure 1A). She did not complain of pain and morning stiffness about the shoulders, neck, hip girdle, and proximal thighs. There were no complications of polymyalgia rheumatica. Her C-reactive protein level was 4.8 mg/dL (reference: 0–0.3 mg/dL), and erythrocyte sedimentation rate was 85 mm/h (reference: 0–10 mm/h). Ultrasonography revealed thickened walls in both the temporal artery frontal branches (Figure 1B; left temporal artery). Giant-cell arteritis (GCA) was considered likely.1 Left temporal artery biopsy was performed, which revealed a highly narrowed lumen. Lymphocytes, neutrophil infiltration, and granulation tissue formation were observed in the blood vessel wall, and multinucleated giant cells were also observed. The biopsy results confirmed the diagnosis, and 40 mg prednisolone (1 mg/kg body weight) was orally administered daily.1 Symptoms resolved within a week.
Giant-cell arteritis is a vasculitis that often affects medium- and large-sized arteries and shows a variety of clinical manifestations (Table 1). Headache is present in over 80% of cases in a report.2 Our patient complained of toothache, but she had no problems with her teeth. Giant-cell arteritis can also cause serious risks, such as blindness,3 and requires prompt diagnosis. Giant-cell arteritis occurs less often in Japan, Korea, and other Asian countries than in Western countries; the reason for this discrepancy remains unclear. In Asian countries, GCA is one of the cause of fever of unknown origin. In primary care settings, the possibility of GCA should be considered in elderly Asian patients suffering from fever and pain in the temple; ultrasonography should be performed to detect wall thickening in the temporal artery frontal branches. This easy method is very useful for the diagnosis of this emergent disease.
None.
No potential conflict of interest relevant to this article was reported.
None.
We obtained informed consent from the patient for this case report.
None.
Eppikajutsuto (EPTJ) is used to reduce redundant body fluids and suppress inflammation. We observed that EPTJ shortened the duration of treatment in an elderly patient with burn injuries. A 96-year-old man suffered superficial partial-thickness burns on the dorsum of his right hand and left knee. The injuries showed early improvement with the use of EPTJ. This suggests that EPTJ could contribute to shortening the duration of healing for superficial partial-thickness burns in elderly patients who may experience slow wound healing and have a high mortality rate. Eppikajutsuto needs to be considered as a treatment for burns in primary care.
The current Japanese hypertension management guidelines (2019) recommend regular exercise for all patients with hypertension. However, limited evidence is available regarding the prevalence of exercise habits in these patients. Therefore, we examined the proportion of participants who met the recommendations on exercise in the Japanese hypertension management guidelines (2019) using a nationally representative sample.
Participants aged ≥20 years from the Japanese National Health and Nutrition Examination Survey conducted from 2013 to 2018 were included. Participants with hypertension were defined as those with blood pressure level ≥140/90 mmHg or those who used antihypertensive drugs. Adherence to the guideline recommendations, stratified by gender, age category, blood pressure level, and medication status, was examined.
This study included 13,414 participants with hypertension (age 68.2 ± 11.7 years, 48.1% men). Among them, 31.8% of participants with hypertension (36.8% of men and 27.3% of women) met the guidelines. Regarding age, the 20–64 years age group had the lowest proportion of patients who met the guidelines (22.4%), followed by those in the 65–74 (37.7%) and ≥75 years age groups (34.5%). Adherence to the guidelines did not significantly differ according to blood pressure levels (<120/<80, 120–129/<80, 130–139/80–89, 140–159/90–99, and 160–179/100–109 mmHg) and presence of antihypertensive medications.
One-third of participants with hypertension engaged in exercise as recommended by the current hypertension management guidelines. Promotion of exercise therapy and monitoring exercise habits among participants with hypertension is warranted.
The aim of this study was to investigate the frequency, effectiveness, and reasons for the use of artificial hydration (AH) in senile patients in the last week, and patient-related factors associated with its usage.
Between April and May 2023, I conducted a cross₋sectional study among medical institutions affiliated with the Japan Network of Home Care Supporting Clinics. Eligible cases included those in which senility was listed as the cause of death on the death certificate from January 1, 2022, to December 31, 2022. The questions asked use of AH, reasons for AH, and symptoms that improved or worsened with AH. Patient characteristics, including age, gender, place of death, length of treatment, and complication of dementia, were also asked. Descriptive statistics were performed. Univariate and multivariate analyses were conducted to examine the association between patient characteristics and the use of AH.
Eighty-three medical institutions (12.5%) provided responses, contributing a total of 714 cases. AH was administered in 236 cases (33.1%). The most common reason was “due to family preference” in 110 cases (46.6%). One hundred thirty-five cases (57.2%) reported “no improved symptoms,” while symptom worsening was reported as “no worsened symptoms” in 176 cases (74.6%). Multivariate analysis on 699 cases using complete-case analysis identified age (risk ratio [RR]:0.98, 95% confidence interval [CI]: 0.96–0.99) and female (RR:0.73, 95% CI:0.58–0.92) as factors associated with the use of AH.
This study revealed that AH was commonly used based on family preferences and to alleviate psychological burdens on the family.
Rubella and measles are two highly contagious viral childhood diseases. However, the high possibility of brutal effects of both microorganisms during pregnancy has kept them emerging as a major public health issue. The current study aimed to investigate the seroprevalence of rubella and measles among 15–25-year-old females in southwest Iran.
This descriptive study was performed in Jahrom, southern west Iran during 2012. Serum samples from female individuals with an age of 15–25 years visiting main laboratories in our study location were collected and evaluated by a commercial ELISA kit for anti-rubella and measles IgG antibodies.
Among the 179 participants, regarding anti-rubella antibodies, 171 (95.0%) were positive, 3 (1.7%) were negative, and 6 (3.3%) were borderline. Regarding anti-measles antibodies, 166 (92.2%) of the subjects were positive, 1 (5.6%) was negative, and 13 (17.2%) were borderline. By assuming a positive value for the borderline cases, the ultimate findings demonstrated that 98.3% and 99.4% of the participants were immune against rubella and measles, respectively. There was no statistically significant association between measles and rubella immunity with age or the use of immunosuppressor medication.
Implementation of vaccine program has obtained significant immunity level in inhabitants, particularly women of childbearing age who play a more important role in herd immunity. Therefore, maintaining the national immune screening against rubella and measles is needed to take into consideration to maintain the current satisfactory level of immunization.
A 38-year-old pathologist developed multiple evanescent white dot syndrome (MEWDS). He documented his visual impairment in detail utilizing a light microscope for pathological diagnosis. Notably, the subjective defects illustrated by the patient were in good spatiotemporal agreement with diagnostic outcomes. The present report enhances the understanding of visual impairment associated with MEWDS through a comparative analysis of subjective experiences and objective clinical findings.
Hepatocellular carcinoma (HCC) is the fifth leading cause of cancer worldwide and majority cases are diagnosed at an intermediate or advanced stage. Per our analysis, greater availability of primary care physicians correlates with lower HCC-related mortality. Our results underscore the need for efforts to expand access to primary care among all populations, especially African Americans, to improve overall HCC-related outcomes.
The COVID-19 pandemic has impacted healthcare behaviors, leading to fewer pediatric visits in Japan and potentially fewer visits by adult patients. However, existing Japanese studies on treatment interruptions have generally relied on questionnaire-based methods. In this study, we assessed the impact of the pandemic on antihypertensive treatment interruption using real-world prescription data.
We conducted an interrupted time series analysis using the National Health Insurance Database in Okayama Prefecture, Japan. Participants included individuals aged 40–69 years with at least one antihypertensive prescription between 2018 and 2020. Treatment interruption was defined as a 3-month or longer gap in prescriptions after medication depletion. We used segmented Poisson regression with models unadjusted and adjusted for seasonality and over-dispersion to assess monthly treatment interruptions before and after Japan's April 2020 emergency.
During the study period, 23.0% of 55,431 participants experienced treatment interruptions. Cyclical fluctuations in interruptions were observed. The crude analysis indicated a 1.2-fold increase in treatment interruptions following the pandemic; however, the adjusted models showed no significant changes. Even among higher-risk groups, such as women, younger adults, and those with shorter prescriptions, no significant alterations were observed.
We found no significant impact of the COVID-19 pandemic on antihypertensive treatment interruption in Okayama Prefecture. The less severe outbreak in the area or increased use of telemedicine and extended prescriptions may have contributed to treatment continuity. Further research is needed using a more stable and comprehensive database, broader regional data, and detailed prescription records to validate and extend our findings.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：