Internal medicine
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Cancer cachexia, which is characterized by weight loss and muscle weakness, is common in patients with pancreatic cancer. Anamorelin, a ghrelin receptor agonist, has shown potential for the management of cachexia in various cancers. ⋯ Cachexia's complex metabolic changes make treatment difficult; however, anamorelin's appetite and weight gain effects highlight its possible role in managing cachexia in pancreatic cancer. Therefore, further research is required in this regard.
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Background The etiology of liver cancer is changing to metabolic dysfunction-associated steatotic liver disease, and ultrasound elastography is useful for identifying high-risk patients. However, these regional differences remain unclear. We aimed to investigate regional differences in the prevalence of liver cancer and the use of ultrasound elastography in Japan using the National Database of Health Insurance Claims (NDB). ⋯ Conclusion The morbidity of liver cancer and diabetes-related diseases is higher in Western Japan. However, ultrasound elastography is not widely used in Japan. There is an urgent need to promote awareness of ultrasound elastography to screen patients at high risk for liver cancer, particularly in Western Japan.
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Idiopathic multicentric Castleman disease (iMCD) accompanied by thrombocytopenia, anasarca, fever, reticulin myelofibrosis/renal insufficiency, and organomegaly (TAFRO) frequently develops into prolonged severe thrombocytopenia and multiorgan dysfunction, which is associated with a high mortality rate. We herein describe three cases of iMCD-TAFRO in which serum soluble interleukin-2 receptor (sIL-2R) levels varied in relation to disease activity following the initiation of treatment. Thrombocytopenia persisted for several weeks to months after the normalization of the patients' C-reactive protein levels, whereas their sIL-2R levels normalized 10-47 days prior to platelet recovery (≥100×109/L). The serum sIL-2R measurement may therefore be an effective method for evaluating the disease activity in iMCD-TAFRO patients with prolonged thrombocytopenia.
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We describe the case of a 25-year-old male with Duchenne muscular dystrophy and acute kidney injury who was receiving mechanical ventilation. The patient's estimated glomerular filtration rate (eGFR) was assessed using formulas based on creatinine, cystatin C, and inulin levels over time during the recovery of his renal function. ⋯ The Cystatin C-based eGFR was also higher than the inulin clearance. These findings suggest that cystatin C-based eGFR may also exceed inulin clearance in patients with an extremely reduced fat mass, in addition to a reduced muscle mass.
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Anemia is not known to cause intermittent claudication. We herein present the case of a 74-year-old male patient with intermittent claudication, in whom the primary symptom was severe iron-deficiency anemia. ⋯ This case highlights the need to consider anemia in the differential diagnosis of patients presenting with intermittent neurogenic claudication. A comprehensive evaluation, including tests to rule out anemia, is crucial for making an accurate diagnosis and carrying out the appropriate management of intermittent claudication.