Internal medicine
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Case Reports
Tako-tsubo cardiomyopathy complicated by recurrent torsade de pointes in a patient with anorexia nervosa.
We report the case of a 57-year-old woman with anorexia nervosa showing evidence of "tako-tsubo" cardiomyopathy complicated by several syncopes due to recurrent episodes of torsades de pointes. Prolongation of QT interval and QT dispersion have been reported both in the "tako-tsubo" cardiomyopathy and in anorexia nervosa. The QT prolongation and the QT dispersion has been linked as risk indicators for sudden cardiac death. The combination of "tako-tsubo" cardiomyopathy with a condition associated with the prolongation of QT and/or with an increase of QT dispersion, such as anorexia nervosa, makes the acute and subacute prognosis of this disease much more severe than usual.
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Several lines of evidence from studies involving both general and non-diabetic populations have shown that a family history of diabetes was associated with an increased risk for cardiovascular diseases and metabolic alterations. However, little is known about the relationship of a family history of diabetes to glycemic control and metabolic risks among people with diabetes. ⋯ Diabetic adults with a higher familial risk of diabetes have a worse glycemic control, higher BMI, and higher triglycerides. Obtaining family history of the disease is crucial in identifying and targeting high risk diabetic patients who may require more stringent lifestyle changes as well as pharmaceutical intervention.
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Comparative Study
Comparison between high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as an inflammatory component of metabolic syndrome in Japanese.
To compare two systemic inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC), as a component of metabolic syndrome (MetS). ⋯ Hs-CRP is superior to WBC as an inflammatory component of MetS in Japanese. However, WBC may be useful when hs-CRP is not available because WBC is routinely measured in clinical practice.
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Review Case Reports
Subacute longitudinal myelitis associated with Behcet's disease.
In neuro-Behcet's disease (NBD), myelitis is a rare clinical form. We report the case of a woman with NBD presenting with unsteady gait and generalized spasticity. ⋯ Longitudinal myelitis involving the entire spinal cord, as seen in our patient, has never been described before. This case suggests that NBD could be one of the important differential diagnoses of longitudinal myelitis.
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A 71-year-old man developed postural tremor and was treated as an essential tremor patient. Nine years after the tremor onset, he developed symptoms resembling Fragile-X-associated tremor/ataxia syndrome (FXTAS), including exacerbated (increased coarseness and amplitude) tremor in the right arm, ataxic gait, and brain MRI showed lesions in the bilateral middle cerebellar peduncles (MCP). ⋯ FXTAS causes various neurological symptoms including in some cases tremor resembling essential tremor in the early stages. FMR1 gene premutation should be checked when the patient develops intention tremor, cerebral dysfunction and/or a brain MRI shows MCP lesions.