Internal medicine
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Objective Pancreatic cystic lesions (PCLs) are known risk factors for pancreatic cancer. Therefore, this study explored the predictors identifying PCLs in a general population and developed a scoring system to help more efficiently diagnose these entities during medical checkups. Methods We reviewed 9,369 examinees of abdominal ultrasound (AUS) during medical checkups between January 2013 and November 2019. ⋯ The PCL detection rate increased with the total score: 0.2% for total score 0 point, 5.4% for ≥4.0 points. The area under the curve of the scoring system was 0.75 (95% CI 0.70-0.79). Conclusion Our scoring system allows the risk of PCLs to be determined and may help more efficiently diagnose these entities.
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Many patients with primary vitreoretinal lymphoma (PVRL) exhibit central nervous system (CNS) involvement either at the diagnosis or during follow-up. The prognosis in the patients of PVRL with relapsed or refractory CNS remains extremely poor. ⋯ The patient surprisingly responded to tirabrutinib temporarily. We believe that this case suggests the utility of this new target therapy.
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Case Reports
Two Cases of Acute Gastric Mucosal Lesions Due to Helicobacter pylori Infection Confirmed to be Transient Infection.
Two adult cases of acute gastric mucosal lesions (AGML) caused by Helicobacter pylori infection were confirmed by spontaneous eradication during the follow-up period. The clinical course of the initial infection by H. pylori in adults with AGML remains unclear, whether it is transient or progresses to a persistent infection. In these two reported cases, gastric biopsies at the time of the onset revealed the presence of H. pylori; however, serum H. pylori antibodies performed at the same time were negative. Retesting for H. pylori serum antibody, after six months in one and after two months in the other, was negative, confirming spontaneous eradication.
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An 82-year-old woman complained of recurring cough and shortness of breath and was diagnosed with progressive multiple myeloma (MM). Chest computed tomography (CT) revealed bilateral ground-glass opacity and interlobular septal thickening predominantly in the lower lung zones. ⋯ Aggressive chemotherapy for MM contributed to the improvement in respiratory symptoms and abnormal chest CT findings. In cases of MM with lung abnormalities, the possibility of GLILD must be ruled out, and a TBLC should be considered to attain an accurate diagnosis.
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Objective In the Japanese Community-Based Integrated Care System (CBICS), access to formal care services is based on voluntary consultations mainly from the families of people with dementia (PWD). The problem is that some people need services but do not consult their municipalities for various reasons. The purpose of this study is to examine the possibility of using health insurance claims data to identify and characterize these PWD. ⋯ As a result, seven of these PWD started using long-term care insurance services or dementia prevention services. Conclusion PWD not accessing the CBICS can be identified using health insurance claims data. The results proved that the municipality has a cost-effective way of providing their services to PWD and their families, even if they have never consulted voluntarily.