Nihon rinsho. Japanese journal of clinical medicine
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One of the advances in recent years about the treatment of hepatocellular carcinoma is clinical evidence of the molecular target drug, sorafenib. Although sorafenib shows little anti-tumor effect indicated by tumor shrinkage, it has inhibitory effect of tumor development to be the first drug shown to extend survival in hepatocellular carcinoma. ⋯ Position of sorafenib in the treatment of hepatocellular carcinoma among hepatic arterial infusion chemotherapy and transcatheter arterial embolization is not yet clear. Many clinical trials of molecular target drugs against hepatocellular carcinoma are underway.
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In Japan, about 20 million people were infected with pandemic (H1N1) 2009 virus between July 2009 and March 2010. About 60% of them were under 15 years, but only 38 pediatric deaths were reported. ⋯ The time from onset to appear dyspnea in patients with lower respiratory complications was very short, and encephalopathy also appears very rapidly. It is very important to observe clinical course closely and to start neuraminidase inhibitor within 48 hours.
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Pandemic influenza H1N1 2009 caused more severe diseases in children and young adults than seasonal influenza. The typical manifestation of severe diseases was diffuse viral pneumonia complicated with acute respiratory distress syndrome. Over half of the severe cases had underlying conditions, in which pregnancy and morbid obesity were regarded as major risk factors. ⋯ The level of plasma cytokines was also elevated in the severe cases. Antiviral use was generally recommended for the severe cases and might improve the outcomes. Further studies are needed for better clinical management of the severe cases of the latest pandemic influenza.