Internal medicine
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We report a case of acute respiratory distress syndrome (ARDS) after influenza A infection who was successfully treated with combined treatment including direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) column. A 56-year-old Japanese man was admitted to our hospital in January 2010 because of progressive dyspnea, hypoxemia, fever and bilateral diffuse infiltration on chest radiograph after pandemic influenza A infection. ⋯ The patient was successfully treated with PMX-DHP in addition to the treatment with oseltamivir, corticosteroid, sivelestat and antibiotics with mechanical ventilation, and the patient recovered with only minor pulmonary fibrotic change. Although the efficacy of PMX-DHP treatment in patients with acute lung injury (ALI)/ARDS after influenza virus infection is not well established, this treatment could be a possible therapeutic modality in treating the patients with this disease.
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Although oral antithrombotic therapy (OAT) is a risk factor of intracerebral hemorrhage (ICH), the clinical course of supratentorial ICH with prior OAT is unclear. We therefore assessed the characteristics of supratentorial ICH with OAT to determine whether OAT is independently associated with early death in supratentorial ICH. ⋯ The OA group patients were older, their GCS was lower, they had larger hematoma volume, and more frequent occurrence of early death. Prior oral antithrombotic therapy is associated with early death in patients with supratentorial ICH.
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Autoimmune pancreatitis (AIP) and Mikulicz's disease have recently been recognized as pancreatic or salivary gland lesions of IgG4-related systemic disease. These are frequently associated with elevated serum IgG4 levels. This study aimed to clarify clinical implications of serial changes of elevated serum IgG4 levels in IgG4-related systemic diseases. ⋯ Measurement of serial serum IgG4 levels is useful to determine the disease activity of IgG4-related systemic diseases.
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Comparative Study
Health education "Hokenshido" program reduced metabolic syndrome in the Amagasaki visceral fat study. Three-year follow-up study of 3,174 Japanese employees.
The aim of this study was to evaluate the effects of health checkup and the health education "Hokenshido" program based on the concept that visceral fat accumulation causes metabolic syndrome (MetS), leading to cardiovascular disease (CVD). ⋯ Health check-up and the "Hokenshido" program reduced the prevalence of the MetS, which might lead to prevention of CVD.
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Body fat is an important source of hormones and cytokines (adipokines) that not only regulate the energy balance, but also regulate the inflammatory and immune responses. This study investigated the association of clinical conditions with serum levels of adipokines in patients with rheumatoid arthritis. ⋯ The serum levels of resistin and leptin were positively associated with CRP level in patients with rheumatoid arthritis, suggesting that these adipokines may act as pro-inflammatory cytokines in this disease. The serum adiponectin level was elevated in the patients, however, it was negatively associated with CRP level. In addition, the serum levels of resistin, leptin, and adiponectin were also associated with female sex, BMI and the use of prednisolone, respectively.