Pub Date : 2022-05-31DOI: 10.2169/internalmedicine.9752-22
Kazuki Matsumura, H. Kawano, M. Kurobe, Ryohei Akashi, T. Yoshimuta, S. Ikeda, Nozomi Ueki, M. Nakashima, K. Maemura
A 41-year-old Japanese man was admitted to our hospital with acute perimyocarditis 4 weeks after coronavirus disease 2019 (COVID-19) infection. Ten days after admission, the patient showed bilateral facial nerve palsy in the course of improvement of perimyocarditis under treatment with aspirin and colchicine. After prednisolone therapy, perimyocarditis completely improved, and the facial nerve palsy gradually improved. Acute perimyocarditis and facial nerve palsy can occur even 4 weeks after contracting COVID-19.
{"title":"Delayed Acute Perimyocarditis and Bilateral Facial Nerve Palsy in a Patient with COVID-19","authors":"Kazuki Matsumura, H. Kawano, M. Kurobe, Ryohei Akashi, T. Yoshimuta, S. Ikeda, Nozomi Ueki, M. Nakashima, K. Maemura","doi":"10.2169/internalmedicine.9752-22","DOIUrl":"https://doi.org/10.2169/internalmedicine.9752-22","url":null,"abstract":"A 41-year-old Japanese man was admitted to our hospital with acute perimyocarditis 4 weeks after coronavirus disease 2019 (COVID-19) infection. Ten days after admission, the patient showed bilateral facial nerve palsy in the course of improvement of perimyocarditis under treatment with aspirin and colchicine. After prednisolone therapy, perimyocarditis completely improved, and the facial nerve palsy gradually improved. Acute perimyocarditis and facial nerve palsy can occur even 4 weeks after contracting COVID-19.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2327 - 2332"},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44496256","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 : 2022-05-21DOI: 10.2169/internalmedicine.9268-21
H. Fujikawa, Toshichika Mitsuyama, Daisuke Son, M. Izumiya, Masato Eto
Objective Vaccination technique is a crucial skill for medical trainees to learn, especially in the current coronavirus disease 2019 pandemic. To this end, validated assessment tools are essential in teaching appropriate techniques. However, valid instruments for assessing vaccine administration skills have not yet been developed. We therefore explored the development and validation of an assessment tool for vaccination techniques based on expert consensus. Methods We implemented a modified Delphi process to develop a vaccination technique assessment tool. We then conducted a validation study to establish the reliability and validity of the tool. Results Two rounds of the modified Delphi process were performed to generate a 19-item, vaccination performance assessment checklist. In the validation study, the linear weighted kappa value for inter-rater reliability of the overall checklist score was 0.725. Spearman's correlation coefficient between the mean checklist score and the global rating was 0.98 (p<0.01). Conclusions This is a pioneering study examining the development and validation of an assessment tool for vaccine administration techniques. The tool will be widely used in vaccination-related education.
{"title":"Development and Validation of a Performance Assessment Checklist Scale for Vaccine Administration","authors":"H. Fujikawa, Toshichika Mitsuyama, Daisuke Son, M. Izumiya, Masato Eto","doi":"10.2169/internalmedicine.9268-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.9268-21","url":null,"abstract":"Objective Vaccination technique is a crucial skill for medical trainees to learn, especially in the current coronavirus disease 2019 pandemic. To this end, validated assessment tools are essential in teaching appropriate techniques. However, valid instruments for assessing vaccine administration skills have not yet been developed. We therefore explored the development and validation of an assessment tool for vaccination techniques based on expert consensus. Methods We implemented a modified Delphi process to develop a vaccination technique assessment tool. We then conducted a validation study to establish the reliability and validity of the tool. Results Two rounds of the modified Delphi process were performed to generate a 19-item, vaccination performance assessment checklist. In the validation study, the linear weighted kappa value for inter-rater reliability of the overall checklist score was 0.725. Spearman's correlation coefficient between the mean checklist score and the global rating was 0.98 (p<0.01). Conclusions This is a pioneering study examining the development and validation of an assessment tool for vaccine administration techniques. The tool will be widely used in vaccination-related education.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2295 - 2300"},"PeriodicalIF":0.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41616052","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 : 2022-05-21DOI: 10.2169/internalmedicine.9179-21
Kana Takayama, Y. Obata, Yumiko Maruo, Hiroki Yamaguchi, Motohiro Kosugi, Y. Irie, Yoji Hazama, T. Yasuda
Metformin-associated lactic acidosis (MALA) is an extremely rare but life-threatening adverse effect of metformin treatment. The lifestyle changes associated with the coronavirus disease 2019 (COVID-19) pandemic may increase the potential risk of MALA development in patients with diabetes. We herein report a 64-year-old Japanese man taking a small dose of metformin who presented with MALA accompanied by hypoglycemia secondary to increased alcohol consumption triggered by lifestyle changes during the pandemic. Physicians should prescribe metformin judiciously to prevent MALA development and pay close attention to lifestyle changes in patients at risk for MALA during the COVID-19 pandemic.
{"title":"Metformin-associated Lactic Acidosis with Hypoglycemia during the COVID-19 Pandemic","authors":"Kana Takayama, Y. Obata, Yumiko Maruo, Hiroki Yamaguchi, Motohiro Kosugi, Y. Irie, Yoji Hazama, T. Yasuda","doi":"10.2169/internalmedicine.9179-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.9179-21","url":null,"abstract":"Metformin-associated lactic acidosis (MALA) is an extremely rare but life-threatening adverse effect of metformin treatment. The lifestyle changes associated with the coronavirus disease 2019 (COVID-19) pandemic may increase the potential risk of MALA development in patients with diabetes. We herein report a 64-year-old Japanese man taking a small dose of metformin who presented with MALA accompanied by hypoglycemia secondary to increased alcohol consumption triggered by lifestyle changes during the pandemic. Physicians should prescribe metformin judiciously to prevent MALA development and pay close attention to lifestyle changes in patients at risk for MALA during the COVID-19 pandemic.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2333 - 2337"},"PeriodicalIF":0.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41632636","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 27-year-old woman with hypothyroidism and depression consulted for headache, ocular discharge, bilateral eyeache, and eyelid swelling for 2 weeks. A physical examination showed the disappearance of upper eyelid crease, edema, bilateral superior eyelid redness (Picture A), cervical lymphadenopathies, and meningeal irritation. The total white blood cell count, atypical lymphocyte percentage, and aspartate and alanine aminotransferase levels were 9,260/μL, 10%, 47 U/L, and 56 U/L, respectively. Orbital computed tomography showed swollen eyelids and lacrimal glands (Picture B). Short-T1 intervention recovery magnetic resonance imaging showed isointensity signals to the eyeball (Picture C), indicating acute dacryoadenitis (AD). EpsteinBarr virus (EBV) viral capsid antigen IgM, 1:20; VCA IgG, 1:1,280; EBV nuclear antigen IgG, negative; and EBV-DNA, 4.5×10 copies/mL supported bilateral AD associated with EBV infectious mononucleosis (IM). With supportive care, her eyelid edema and elevated liver enzymes subsided (Picture D) after 14 days. EBV targets B lymphocytes and epithelial cells. Dacryoadenitis occurs in IM (1) and affects one per million people annually (2). EBV infection should be considered in young adults with AD.
{"title":"Epstein-Barr Virus Dacryoadenitis in a Young Woman","authors":"Tamami Watanabe, Takeshi Yamashita, Hitoshi Sugawara","doi":"10.2169/internalmedicine.8004-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.8004-21","url":null,"abstract":"A 27-year-old woman with hypothyroidism and depression consulted for headache, ocular discharge, bilateral eyeache, and eyelid swelling for 2 weeks. A physical examination showed the disappearance of upper eyelid crease, edema, bilateral superior eyelid redness (Picture A), cervical lymphadenopathies, and meningeal irritation. The total white blood cell count, atypical lymphocyte percentage, and aspartate and alanine aminotransferase levels were 9,260/μL, 10%, 47 U/L, and 56 U/L, respectively. Orbital computed tomography showed swollen eyelids and lacrimal glands (Picture B). Short-T1 intervention recovery magnetic resonance imaging showed isointensity signals to the eyeball (Picture C), indicating acute dacryoadenitis (AD). EpsteinBarr virus (EBV) viral capsid antigen IgM, 1:20; VCA IgG, 1:1,280; EBV nuclear antigen IgG, negative; and EBV-DNA, 4.5×10 copies/mL supported bilateral AD associated with EBV infectious mononucleosis (IM). With supportive care, her eyelid edema and elevated liver enzymes subsided (Picture D) after 14 days. EBV targets B lymphocytes and epithelial cells. Dacryoadenitis occurs in IM (1) and affects one per million people annually (2). EBV infection should be considered in young adults with AD.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"1629 - 1629"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48794900","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}
Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.
{"title":"Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination","authors":"Bonpei Takase, Katsumi Hayashi, S. Takei, Tetsuya Hisada, Nobuyuki Masaki, Masayoshi Nagata","doi":"10.2169/internalmedicine.9318-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.9318-21","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2167 - 2170"},"PeriodicalIF":0.0,"publicationDate":"2022-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48671645","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 : 2022-05-07DOI: 10.2169/internalmedicine.9065-21
Yuta Nanjo, Tomoko Okuma, Yumi Kuroda, E. Hayakawa, Kohei Shibayama, Takashi Akimoto, Ryoko Murashima, K. Kanamori, T. Tsutsumi, Yohei Suzuki, Y. Namba, F. Makino, O. Nagashima, S. Sasaki, Kazuhisa Takahashi
Objective Based on the increasing incidence of smell and taste dysfunction among coronavirus disease 2019 (COVID-19) patients, such issues have been considered an early symptom of infection. However, few studies have investigated the type of taste components that are most frequently affected in COVID-19 patients. This study investigated the difference in frequencies of the types of taste component disorders among hospitalized COVID-19 patients. Methods In this retrospective, single-center, observational study, patients' background characteristics, clinical course, laboratory and radiological findings, and details on taste and/or smell disorders were collected and analyzed from medical records. Patients A total of 227 COVID-19 patients were enrolled, among whom 92 (40.5%) complained of taste disorders. Results Multiple types of taste disorders (hypogeusia/ageusia and hypersensitivity, or hypersensitivity and changing tastes) were reported in 10 patients. In particular, 23 patients reported hypersensitivity to at least 1 type of taste, and 2 patients complained of a bitter taste on consuming sweet foods. Impairment of all taste components was found in 48 patients (52.2%). The most frequent taste disorder was salty taste disorder (81 patients, 89.0%). Hypersensitivity to salty taste was most frequently observed (19 patients, 20.9%). Conclusion Patients with COVID-19 develop multiple types of taste disorders, among which salty taste disorder was the most frequent, with many patients developing hypersensitivity to salty taste. As smell and taste are subjective senses, further studies with the combined use of objective examinations will be required to confirm the findings.
{"title":"Multiple Types of Taste Disorders among Patients with COVID-19","authors":"Yuta Nanjo, Tomoko Okuma, Yumi Kuroda, E. Hayakawa, Kohei Shibayama, Takashi Akimoto, Ryoko Murashima, K. Kanamori, T. Tsutsumi, Yohei Suzuki, Y. Namba, F. Makino, O. Nagashima, S. Sasaki, Kazuhisa Takahashi","doi":"10.2169/internalmedicine.9065-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.9065-21","url":null,"abstract":"Objective Based on the increasing incidence of smell and taste dysfunction among coronavirus disease 2019 (COVID-19) patients, such issues have been considered an early symptom of infection. However, few studies have investigated the type of taste components that are most frequently affected in COVID-19 patients. This study investigated the difference in frequencies of the types of taste component disorders among hospitalized COVID-19 patients. Methods In this retrospective, single-center, observational study, patients' background characteristics, clinical course, laboratory and radiological findings, and details on taste and/or smell disorders were collected and analyzed from medical records. Patients A total of 227 COVID-19 patients were enrolled, among whom 92 (40.5%) complained of taste disorders. Results Multiple types of taste disorders (hypogeusia/ageusia and hypersensitivity, or hypersensitivity and changing tastes) were reported in 10 patients. In particular, 23 patients reported hypersensitivity to at least 1 type of taste, and 2 patients complained of a bitter taste on consuming sweet foods. Impairment of all taste components was found in 48 patients (52.2%). The most frequent taste disorder was salty taste disorder (81 patients, 89.0%). Hypersensitivity to salty taste was most frequently observed (19 patients, 20.9%). Conclusion Patients with COVID-19 develop multiple types of taste disorders, among which salty taste disorder was the most frequent, with many patients developing hypersensitivity to salty taste. As smell and taste are subjective senses, further studies with the combined use of objective examinations will be required to confirm the findings.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2127 - 2134"},"PeriodicalIF":0.0,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43034475","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 : 2022-05-01DOI: 10.2169/internalmedicine.7897-21
S. Miyazaki, T. Hamada, S. Sugihara, E. Mizuta, Yusuke Endo, A. Ohtahara, K. Komatsu, M. Kuwabara, T. Fukuuchi, K. Kaneko, K. Ichida, K. Ogino, H. Ninomiya, K. Yamamoto, Takashi Nakamura, I. Hisatome
Whether or not extremely low levels of serum uric acid (SUA) in xanthinuria are associated with impairment of the endothelial function and exercise-induced acute kidney injury (EIAKI) is unclear. A 59-year-old woman without EIAKI or urolithiasis had undetectable levels of UA in serum and urine and elevated levels of hypoxanthine and xanthine in urine. A genetic analysis revealed homozygous mutations in the XDH gene [c.1585 C>T (p. Gln529*)]. Flow-mediated dilation was within the normal range. This is the first report of a case with extremely low levels of SUA, xanthinuria with novel mutations of xanthine dehydrogenase (XDH) and a normal endothelial function.
{"title":"Xanthinuria Type 1 with a Novel Mutation in Xanthine Dehydrogenase and a Normal Endothelial Function","authors":"S. Miyazaki, T. Hamada, S. Sugihara, E. Mizuta, Yusuke Endo, A. Ohtahara, K. Komatsu, M. Kuwabara, T. Fukuuchi, K. Kaneko, K. Ichida, K. Ogino, H. Ninomiya, K. Yamamoto, Takashi Nakamura, I. Hisatome","doi":"10.2169/internalmedicine.7897-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.7897-21","url":null,"abstract":"Whether or not extremely low levels of serum uric acid (SUA) in xanthinuria are associated with impairment of the endothelial function and exercise-induced acute kidney injury (EIAKI) is unclear. A 59-year-old woman without EIAKI or urolithiasis had undetectable levels of UA in serum and urine and elevated levels of hypoxanthine and xanthine in urine. A genetic analysis revealed homozygous mutations in the XDH gene [c.1585 C>T (p. Gln529*)]. Flow-mediated dilation was within the normal range. This is the first report of a case with extremely low levels of SUA, xanthinuria with novel mutations of xanthine dehydrogenase (XDH) and a normal endothelial function.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"1383 - 1386"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45539922","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 : 2022-05-01DOI: 10.2169/internalmedicine.7676-21
Hiroyuki Ito, Kiyoko Ito, Mahika Tanaka, Mayumi Hokamura, Mari Tanaka, E. Kusano, Jiro Kondo, Takuma Izutsu, Suzuko Matsumoto, H. Inoue, Shinichi Antoku, T. Yamasaki, Toshiko Mori, Michiko Togane
Objective Diabetes is recognized as an underlying disease of constipation. However, the prevalence of constipation varies according to the diagnostic criteria applied. We investigated the prevalence of constipation based on the new guideline for constipation in Japanese patients with type 2 diabetes and examined the relationship with the clinical background, including diabetic vascular complications. Methods Questionnaire surveys including items concerning the diagnosis and treatment status of constipation were administered to 410 patients with type 2 diabetes. Results Although 29% of the patients considered that they had experienced constipation (self-judged), only 14% had consulted a physician about constipation. The prevalence of chronic constipation based on the guideline was 26%. After including laxative users, constipation was finally found in 36%. Despite the use of laxatives (n=81), 51% of the patients were still diagnosed with chronic constipation. Patients with constipation (chronic constipation or laxative use) were significantly older and had a longer duration of diabetes than those without constipation. The body mass index (BMI) of patients with constipation (24.9±3.8 kg/m2) was significantly lower than that of those without constipation (26.3±4.6 kg/m2). Diabetic neuropathy (49% vs. 32%) and coronary heart disease (CHD) (27% vs. 13%) were significantly more frequent in the patients with constipation than in those without constipation. A multivariate logistic regression analysis revealed that gender, BMI, diabetic neuropathy, insulin use, and CHD were significantly associated with constipation. Conclusion An accurate diagnosis of constipation is desirable in patients with type 2 diabetes because constipation is independently associated with CHD.
{"title":"Constipation Is a Frequent Problem Associated with Vascular Complications in Patients with Type 2 Diabetes: A Cross-sectional Study","authors":"Hiroyuki Ito, Kiyoko Ito, Mahika Tanaka, Mayumi Hokamura, Mari Tanaka, E. Kusano, Jiro Kondo, Takuma Izutsu, Suzuko Matsumoto, H. Inoue, Shinichi Antoku, T. Yamasaki, Toshiko Mori, Michiko Togane","doi":"10.2169/internalmedicine.7676-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.7676-21","url":null,"abstract":"Objective Diabetes is recognized as an underlying disease of constipation. However, the prevalence of constipation varies according to the diagnostic criteria applied. We investigated the prevalence of constipation based on the new guideline for constipation in Japanese patients with type 2 diabetes and examined the relationship with the clinical background, including diabetic vascular complications. Methods Questionnaire surveys including items concerning the diagnosis and treatment status of constipation were administered to 410 patients with type 2 diabetes. Results Although 29% of the patients considered that they had experienced constipation (self-judged), only 14% had consulted a physician about constipation. The prevalence of chronic constipation based on the guideline was 26%. After including laxative users, constipation was finally found in 36%. Despite the use of laxatives (n=81), 51% of the patients were still diagnosed with chronic constipation. Patients with constipation (chronic constipation or laxative use) were significantly older and had a longer duration of diabetes than those without constipation. The body mass index (BMI) of patients with constipation (24.9±3.8 kg/m2) was significantly lower than that of those without constipation (26.3±4.6 kg/m2). Diabetic neuropathy (49% vs. 32%) and coronary heart disease (CHD) (27% vs. 13%) were significantly more frequent in the patients with constipation than in those without constipation. A multivariate logistic regression analysis revealed that gender, BMI, diabetic neuropathy, insulin use, and CHD were significantly associated with constipation. Conclusion An accurate diagnosis of constipation is desirable in patients with type 2 diabetes because constipation is independently associated with CHD.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"1309 - 1317"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43920682","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 : 2022-05-01DOI: 10.2169/internalmedicine.8437-21
K. Katabami, Takashi Kimura, Takumi Hirata, A. Tamakoshi
Objective This study assessed the risk factors of mortality from foreign bodies in the respiratory tract using the Japan Collaborative Cohort Study for the Evaluation of Cancer Risk data. Methods Data of 110,585 participants 40-79 years old living in 45 areas in Japan were collected between 1988 and 2009. Mortality from foreign bodies in the respiratory tract was assessed in a multivariable-adjusted analysis using a Cox proportional hazard regression model. Results Among all participants, 202 deaths occurred from foreign bodies in the respiratory tract. In the multivariable-adjusted model, older age [50-59 (hazard ratio, 4.93; 95% confidence interval, 1.91-12.74), 60-69 (hazard ratio, 14.96, 6.01-37.25) and 70-79 (hazard ratio, 53.81; 95% confidence interval, 21.44-135.02) years old compared to 40-49 years old], male sex (hazard ratio, 2.34; 95% confidence interval, 1.54-3.54), a history of apoplexy (hazard ratio, 7.04; 95% confidence interval, 4.24-11.67) and the absence of a spouse (hazard ratio, 1.56; 95% confidence interval, 1.05-2.32) were associated with an increased risk of mortality from foreign bodies in the respiratory tract. Conclusions Older age, male sex, medical history of apoplexy and the absence of a spouse were potential risk factors of mortality from foreign bodies in the respiratory tract. Especially in elderly men, social connections, such as cohabitation or relationships, may be important for ensuring the early detection of asphyxia and preventing death due to foreign bodies in the respiratory tract.
{"title":"Risk Factors of Mortality from Foreign Bodies in the Respiratory Tract: The Japan Collaborative Cohort Study","authors":"K. Katabami, Takashi Kimura, Takumi Hirata, A. Tamakoshi","doi":"10.2169/internalmedicine.8437-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.8437-21","url":null,"abstract":"Objective This study assessed the risk factors of mortality from foreign bodies in the respiratory tract using the Japan Collaborative Cohort Study for the Evaluation of Cancer Risk data. Methods Data of 110,585 participants 40-79 years old living in 45 areas in Japan were collected between 1988 and 2009. Mortality from foreign bodies in the respiratory tract was assessed in a multivariable-adjusted analysis using a Cox proportional hazard regression model. Results Among all participants, 202 deaths occurred from foreign bodies in the respiratory tract. In the multivariable-adjusted model, older age [50-59 (hazard ratio, 4.93; 95% confidence interval, 1.91-12.74), 60-69 (hazard ratio, 14.96, 6.01-37.25) and 70-79 (hazard ratio, 53.81; 95% confidence interval, 21.44-135.02) years old compared to 40-49 years old], male sex (hazard ratio, 2.34; 95% confidence interval, 1.54-3.54), a history of apoplexy (hazard ratio, 7.04; 95% confidence interval, 4.24-11.67) and the absence of a spouse (hazard ratio, 1.56; 95% confidence interval, 1.05-2.32) were associated with an increased risk of mortality from foreign bodies in the respiratory tract. Conclusions Older age, male sex, medical history of apoplexy and the absence of a spouse were potential risk factors of mortality from foreign bodies in the respiratory tract. Especially in elderly men, social connections, such as cohabitation or relationships, may be important for ensuring the early detection of asphyxia and preventing death due to foreign bodies in the respiratory tract.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"1353 - 1359"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49646917","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 : 2022-04-23DOI: 10.2169/internalmedicine.9469-22
Kazuaki Aoki, Shungo Yamamoto, Kentaro Tochitani
An 81-year-old man was admitted to our hospital with a fever and headache. His symptoms started 30 days after receiving the second dose of the BNT162b2 messenger ribonucleic acid (mRNA) vaccine against severe acute respiratory coronavirus 2 (SARS-CoV-2). His physical examination findings were unremarkable. A blood test showed that the C-reactive protein level was 100 mg/L, and the erythrocyte sedimentation rate was 75 mm/h. Blood and urine cultures tested negative. Positron emission tomography/computed tomography showed an increased uptake of fluorodeoxyglucose by the large vessels, especially the bilateral brachial, subclavian, and carotid arteries, with standardized uptake values of 3.7, 3.9, and 3.9, respectively. He was tentatively diagnosed with large-vessel vasculitis and prescribed naproxen for two weeks as an antipyretic (1). Subsequently, his symptoms disappeared and did not flare up. Our study suggests that COVID-19 vaccination may trigger inflammation, leading to the development of large-vessel vasculitis (2). However, such cases can be resolved without immunosuppressive therapy.
{"title":"Transient Large-vessel Vasculitis after COVID-19 mRNA Vaccination","authors":"Kazuaki Aoki, Shungo Yamamoto, Kentaro Tochitani","doi":"10.2169/internalmedicine.9469-22","DOIUrl":"https://doi.org/10.2169/internalmedicine.9469-22","url":null,"abstract":"An 81-year-old man was admitted to our hospital with a fever and headache. His symptoms started 30 days after receiving the second dose of the BNT162b2 messenger ribonucleic acid (mRNA) vaccine against severe acute respiratory coronavirus 2 (SARS-CoV-2). His physical examination findings were unremarkable. A blood test showed that the C-reactive protein level was 100 mg/L, and the erythrocyte sedimentation rate was 75 mm/h. Blood and urine cultures tested negative. Positron emission tomography/computed tomography showed an increased uptake of fluorodeoxyglucose by the large vessels, especially the bilateral brachial, subclavian, and carotid arteries, with standardized uptake values of 3.7, 3.9, and 3.9, respectively. He was tentatively diagnosed with large-vessel vasculitis and prescribed naproxen for two weeks as an antipyretic (1). Subsequently, his symptoms disappeared and did not flare up. Our study suggests that COVID-19 vaccination may trigger inflammation, leading to the development of large-vessel vasculitis (2). However, such cases can be resolved without immunosuppressive therapy.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"99 ","pages":"2083 - 2084"},"PeriodicalIF":0.0,"publicationDate":"2022-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41275524","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}
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