Internal medicine
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Objective To calculate the prevalence of anemia based on sex and age using large-scale occupational health examination data, confirm the Hb) distribution in the elderly, and examine the standard for screening for anemia in Japan. Methods Using existing large-scale occupational health examination data of patients who underwent health examinations between April 2015 and March 2022, we calculated the prevalence of anemia based on sex and age. Patients We included 416,366 patients aged 20-89 years who underwent health checkups at health checkup facilities in Japan. ⋯ Furthermore, the mean -2SD of Hb in the elderly men (>65 years) was 12.0 g/dL, larger than the current standard (11.0 g/dL). Conclusion It is imperative to consider the possibility of anemia in young women during health examinations and other screening opportunities, regardless of their history of anemia. In addition, elderly men with Hb levels <12 g/dL should be cautioned about the development of anemic symptoms and the progression of Hb decline.
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Objective Our previous study indicated that the efficacy of metformin in lowering glycated hemoglobin (HbA1c) levels may be influenced by the pretreatment frequency of defecation (FD) in patients with type 2 diabetes mellitus (T2DM). This study aimed to further examine how FD and the metformin dose may affect HbA1c changes (ΔHbA1c) in T2DM patients. Methods A retrospective analysis was conducted on inpatients who received antidiabetic treatment without altering dosages for six months post-discharge, except for minor insulin adjustments. ⋯ A multiple regression analysis identified posttreatment FD and metformin dose as significant independent factors influencing ΔHbA1c levels. Additionally, diabetic peripheral neuropathy and diabetes duration were found to diminish the effectiveness of metformin, likely due to decreased posttreatment FD. Conclusion FD may independently contribute to the dose-dependent HbA1c-lowering effects of metformin.
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A 50-year-old man was diagnosed with type 1 autoimmune pancreatitis (AIP) following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and a histopathological examination. After six months of untreated follow-up, the serum IgG4 level decreased, and the diffuse pancreatic enlargement improved; however, a pancreatic head mass became apparent. ⋯ After pancreatoduodenectomy, AIP did not recur. The development of AIP in this case could be related to paraneoplastic syndrome.
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A 64-year-old man with autosomal dominant polycystic kidney disease (ADPKD) on hemodialysis presented with multiple lung masses. A computed tomography (CT)-guided biopsy revealed non-small-cell lung cancer (NSCLC). A cavitary mass in the right lung indicated primary NSCLC (cT2N1M1a, stage IVA). ⋯ On day 10 post-treatment, he developed acute respiratory failure with diffuse ground-glass opacities on chest CT, indicative of pembrolizumab-induced lung injury. Despite steroid pulse therapy, the patient died on day 13. An autopsy revealed left renal pelvic cancer with lung metastases, highlighting the diagnostic challenges in ADPKD.