Internal medicine
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A 57-year-old woman presented with a fever and left-sided hip and back pain. The hip pain was explained by L3 radiculopathy because the pain was distributed on the L3 dermatome accompanied by allodynia. ⋯ Following percutaneous drainage via ultrasound, both the hip and back pain immediately improved. Paraspinal pyomyositis as well as lesions inside the spinal canal should therefore be considered in the differential diagnosis of patients presenting with fever, back pain, and radiculopathy.
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Randomized Controlled Trial
Assessment of factors associated with the quality of life in Korean type 2 diabetic patients.
This study assessed factors associated with the quality of life (QoL) and investigated the influence of age in 401 Korean type 2 diabetic patients. ⋯ The findings suggest that insulin use, depressive symptoms and a family history of diabetes can be associated with the QoL in Korean type 2 diabetic patients; however, the associations show different patterns of age dependency.
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Case Reports
Therapeutic modality of 11 patients with TTP in a single institution in Miyazaki from 2000 to 2011.
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening generalized disease with pathological features that are termed thrombotic microangiopathies. Since the discovery of the von Willebrand factor-cleaving protease [a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13)], it is widely known that approximately two-thirds of TTP patients have a severe deficiency of ADAMTS13 activity due to gene mutations or acquired autoantibodies to this enzyme. However, the remaining one-third of TTP patients have only moderately reduced or almost normal ADAMTS13 activity. To elucidate the clinical characteristics and outcomes of these two types of TTP, we have retrospectively analyzed the cases of acquired TTP patients treated in a single institution from 2000 to 2011. ⋯ We present herein the detailed clinical courses of 11 patients with TTP and address our experiences with the efficacy of various therapeutic regimens. This case-oriented study should be helpful to the physicians who directly care for TTP patients, and may provide a future direction for developing a more efficient treatment modality.
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Case Reports
Pneumothorax developing for the first time in a 73-year-old woman diagnosed with Birt-Hogg-Dubé syndrome.
Spontaneous pneumothorax in the elderly commonly occurs due to underlying pulmonary diseases, such as chronic obstructive pulmonary disease, interstitial lung disease, lung cancer, etc. A 73-year-old woman developed pneumothorax for the first time that was a clinical clue to a diagnosis of Birt-Hogg-Dubé syndrome (BHDS), an autosomal dominant condition characterized by fibrofolliculomas of the skin, renal tumors and multiple lung cysts predisposing to pneumothorax. Although BHDS patients frequently develop pneumothorax during their twenties to forties, the present case indicates that BHDS should be considered as an underlying cause of pneumothorax in the elderly with undisclosed BHDS.
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Case Reports
Methemoglobinemia induced by trimethoprim-sulfamethoxazole in a patient with systemic lupus erythematosus.
We herein report a case of methemoglobinemia induced by trimethoprim-sulfamethoxazole (TMP/SMX). A 41-year-old woman with systemic lupus erythematosus (SLE) received TMP/SMX for prophylaxis of pneumocystis pneumonia (PCP) on the 7th day of hospitalization. ⋯ We diagnosed the patient with methemoglobinemia induced by TMP/SMX. Methemoglobinemia should be considered in cases of sudden dyspnea following TMP/SMX administration.