Internal medicine
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A 40-year-old Japanese man with human immunodeficiency virus presented with disturbance of consciousness 2 years after dropping out. He was emaciated without any zoster skin lesions, and his CD4+ lymphocyte count was 4 cells/μL. ⋯ Antiretroviral therapy and intravenous acyclovir were administered, and the patient survived with neurological sequelae. VZV encephalitis is rare, particularly among people with AIDS, but it is a significant disease with a poor prognosis.
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Objective Obstructive Sleep Apnea Syndrome (OSAS) causes multiple breathing interruptions during sleep and increases mortality if left untreated. Continuous positive airway pressure (CPAP) therapy improves the prognosis of OSAS; however, patient adherence is often poor. This study investigated the relationship between monthly hospital visits and CPAP adherence to CPAP therapy in patients with OSAS. ⋯ Conclusion The timing of monthly clinic visits significantly affected CPAP adherence, with late-month visits associated with poorer adherence. Visit frequency showed no clear correlation with adherence, suggesting that other factors may have influenced CPAP use. Further supportive interventions can enhance adherence and improve the treatment outcomes.
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Familial Mediterranean fever (FMF) is the most prevalent hereditary autoinflammatory disease and is caused by the MEFV gene. In patients carrying MEFV exon 10 variants, FMF usually develops at an early age. ⋯ Colchicine treatment (0.5 mg/day) improved the patient's symptoms. This is the first case report of an elderly Japanese patient with FMF onset in the 70s carrying the MEFV exon 10 variant.
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We herein report a case of concurrent immune thrombocytopenia (ITP) and ulcerative colitis (UC) that achieved remission following mesalazine treatment. A 16-year-old girl presented with severe thrombocytopenia, abdominal pain, and bloody stool. ⋯ Treatment with mesalazine promptly induced the remission of both ITP and UC, which was sustained. We reviewed 24 previously documented cases in which the simultaneous flares of UC and ITP were successfully managed.
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Objective Screening and surveillance methodologies for Lynch syndrome (LS) in Japan. This study assessed the changes in LS knowledge and practice trends. Methods In 2020 and 2022, 2 questionnaire surveys were administered to 3574 councilors of the Japanese Society of Gastroenterology to assess changes in LS-related knowledge and practices. ⋯ However, the rise in UTS suggests a potential bias from doctors with heightened interest in LS, which may have influenced the findings. Conclusion The number of newly diagnosed and currently monitored patients with LS in Japan has been increasing, likely due to expanded screening practices. However, the potential bias introduced by the increased adoption of UTS should be considered when interpreting these results.