Acta Med Okayama
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Salmonella osteomyelitis is extremely rare; only a few cases have been reported in healthy adults. We describe a case of salmonella osteomyelitis in an otherwise healthy 20-year-old Japanese woman who presented with distal tibial pain. X-ray and magnetic resonance imaging showed a lesion suspected to be a bone cyst. ⋯ The bacterial culture examination yielded salmonella. Surgical drainage and antibiotic treatment were performed, after which no recurrence was observed. To our best knowledge, this is the first report of salmonella osteomyelitis of the distal tibia in an otherwise healthy individual.
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Hepatitis-associated aplastic anemia (HAAA) is an acquired bone marrow failure syndrome that develops after seronegative fulminant hepatitis. Abnormal cytotoxic T-cell activation with cytokine release is a possible pathophysiology. We present the case of a 16-month-old Japanese male who developed HAAA following living-donor liver transplantation for fulminant hepatitis. ⋯ He had been administered tacrolimus for prophylaxis against hepatic allograft rejection. Ten years after the HAAA onset, the patient's bone marrow was found to be slightly hypoplastic. Tacrolimus may be effective in controlling abnormal immune reactions that can cause recurrent impaired hematopoiesis.
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Observational Study
Relationship between Chronic Low Back Pain, Social Participation, and Psychological Distress in Elderly People : A Pilot Mediation Analysis.
Several studies indicated that chronic low back pain (CLBP) worsened psychological distress (PD) and social participation (SP) improved PD. The relationships among CLBP, SP and PD have not been established. Here we investigate whether SP mediates the relationship between CLBP and PD in 96 elderly people. ⋯ By including SP as a parameter, the coefficient of correlation between CLBP and K6 scores varied from 0.333 (p=0.002) to 0.218 (p=0.035). After bootstrapping, 0 was not included in the 95% confidence interval (0.119, 1.913). SP as a mediator may reduce PD in elderly people with CLBP.
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Schwannoma is the most common tumor of the peripheral nerve sheath. However, there have been few reports on schwannoma of the posterior tibial nerve causing tarsal tunnel syndrome. ⋯ After enucleation of this tumor, the patient was asymptomatic and had no related sequelae except for minor numbness in the plantar aspects of his digits. Although schwannoma of the posterior tibial nerve is rare, it should be considered even if a ganglion is clinically suspected.
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Randomized Controlled Trial Clinical Trial
Randomized Controlled Trial of Epidural versus Patient-controlled Intravenous Analgesia for Postoperative Pain Control after Laparoscopic Gastrectomy.
Although epidural analgesia (EDA) is considered standard postoperative analgesia for open gastrectomy, it has been unclear whether EDA has benefits in laparoscopic gastrectomy (LG) because postoperative pain after a laparoscopic procedure is significantly reduced. We are conducting a two-arm, single-center, prospective randomized non-inferiority trial to evaluate the postoperative pain relief of patient-controlled intravenous analgesia (PCIA) compared to EDA. ⋯ The primary endpoint is postoperative pain at 24 h after surgery. This study will clarify the optimal pain management after LG.