Internal medicine
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Mesalazine-induced pericarditis is rare, and most cases occur at the time of treatment initiation. A 30-year-old man with ulcerative colitis who had experienced remission for 2 years with mesalazine 2,000 mg/day subsequently experienced relapse. ⋯ Chest radiography revealed marked cardiac dilation (cardiothoracic ratio, 63%) and echocardiography revealed pericardial effusion. Adverse events associated with mesalazine should be carefully monitored, not only at the time of treatment initiation but also after dose escalation.
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A 70-year-old woman was admitted to our hospital with dyspnea. Atypical cells with multilobated nuclei were observed in the pleural effusion. Diffuse large B-cell lymphoma (DLBCL) was diagnosed based on a cell block analysis. ⋯ The patient's disease was refractory to chemotherapy, and she died within one year. Although flower-like nuclei are typical of adult T-cell lymphoma/leukemia, similar multilobated nuclei may occur in DLBCL. Although multilobated DCBCL have been reported to have a better prognosis than other forms of DLBCL, the abovementioned translocations may have contributed to the patient's aggressive clinical course.
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Non-bacterial thrombotic endocarditis (NBTE) causes myocardial and cerebral infarctions and is associated with advanced stages of malignancy. However, only a few cases of myocardial and cerebral infarctions have been reported in the same patient. We herein report a 47-year-old woman with advanced uterine and ovarian cancer who experienced acute myocardial infarction (MI) after receiving chemotherapeutic intervention for the cancer and hemorrhagic cerebral infarction 1 month after admission for acute MI, attributable to NBTE of the aortic valve. NBTE should be considered in patients with malignancies and life-threatening thromboembolism of important organs.
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Introduction Evidence-based medicine (EBM) competency is crucial for healthcare professionals; however, validated tools to assess EBM skills in Japanese are scarce. This study aimed to develop and validate a Japanese version of the Assessing Competency in EBM (ACE) tool. Methods We translated the ACE tool into Japanese, following international standards, and distributed it online to 99 healthcare professionals and students. ⋯ The median completion time was 847 s (IQR, 577-1,249 s). Conclusion Although the Japanese version of the ACE tool showed some promising aspects, including a quick administration and partial validity, its low internal consistency suggests that refinement is needed before it can be confidently used in Japanese medical education settings. Future studies should focus on improving the tool's reliability, potentially through in-person administration, to develop a robust EBM assessment tool in the Japanese healthcare context.