Internal medicine
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Multicenter Study
Is proton pump inhibitor therapy for reflux esophagitis sufficient?: a large real-world survey of Japanese patients.
Proton pump inhibitors (PPIs) are widely used as the mainstay of treatment for erosive reflux esophagitis, based on the excellent results obtained in clinical trials. However, the endoscopic remission rates in patients treated with PPIs in actual clinical settings have not been fully assessed. We conducted a nationwide survey to evaluate the effectiveness of PPIs based on endoscopic findings in real-world clinical settings. ⋯ This study revealed that approximately 40% of the patients did not achieve remission of erosive esophagitis following PPI therapy for a mean of 1.1 years. This suggests the necessity of providing careful follow-up using periodic endoscopy and appropriately selecting PPI therapy.
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Predictors of the need to initiate noninvasive ventilation (NIV) in stable COPD outpatients with acute exacerbation of chronic obstructive pulmonary disease (COPD-AE) are insufficiently defined. The objective of this study was to investigate predictors of the need to initiate NIV in stable COPD-AE outpatients. ⋯ Our results suggest that the PaCO2 measured in the stable state is an independent significant predictor of the need to initiate NIV in COPD-AE patients who are hospitalized for the first time.
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Disseminated intravascular coagulation (DIC) is often associated with infection and a poor outcome. In this study, useful markers for predicting poor outcomes were examined. ⋯ The outcomes of septic patients primarily depend on the SOFA score and the resolution of DIC, which are related to organ failure.
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Infective endocarditis (IE) continues to be associated with high mortality. The aim of the present study was to identify prognostic predictors for short-term mortality in patients with IE. ⋯ Mild renal dysfunction at the time of admission is an important predictor of early phase mortality in patients with IE.
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The classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has limitations because the condition includes disorders with similar general clinical features, similar characteristics of lung and renal involvement and a positive ANCA serology. A 40-year-old woman was admitted to our hospital for hemoptysis and dyspnea. She had no history of bronchial asthma. ⋯ The patient was ultimately diagnosed with AAV associated with diffuse alveolar hemorrhage, rapidly progressive glomerulonephritis and hypereosinophilia without bronchial asthma. Obtaining a definitive diagnosis of ANCA vasculitis can be very difficult, and the characteristics of this case were not compatible with the findings of typical AVV. We herein report a rare case of AVV.