Clinical Characteristics and Outcomes of Hospital-Acquired Lower Gastrointestinal Bleeding: A Single Centre Retrospective Cohort Study.

Background Lower gastrointestinal bleeding (LGIB) is common in inpatient and outpatient settings; however, there are limited studies on the clinical characteristics and patient outcomes of those with hospital-acquired LGIB. Methods We performed a retrospective cohort study of patients with hospital-acquired LGIB who underwent colonoscopy during hospitalization between January 2017 and December 2021. We described the clinical characteristics, etiology, and clinical outcomes of patients stratified as those undergoing colonoscopy within 24 hours from haematochezia onset (early colonoscopy group) or after 24 hours from onset (late colonoscopy group).

Autoimmune glial fibrillar acidic protein astrocytopathy mimicking tuberculous meningitis.

Autoimmune glial fibrillar acidic protein (GFAP) astrocytopathy typically presents as acute or subacute meningoencephalitis with or without myelitis. We describe a case of autoimmune GFAP astrocytopathy that mimicked tuberculous meningitis. A man in his 70s was referred to our hospital with lethargy persistent for 2 months, appetite loss for 1 month and fever with headache for 10 days.

Usefulness of renal diffusion-weighted magnetic resonance imaging for early diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome.

A teenage girl presented with fever after aspirin use. Examination revealed no organ-specific symptoms. The serum creatinine level and urine analysis findings were normal.

Infected pancreatic necrosis and retroperitoneal abscess associated with .

Infected pancreatic necrosis is a postpancreatitis complication that is mainly caused by Enterobacteriaceae and Enterococci. Here, we have reported a very rare case of bacteraemia associated with infected pancreatic necrosis and retroperitoneal abscess. In addition to the diagnosis of diabetic ketoacidosis, blood test results revealed a high inflammatory status.

Internal jugular vein thrombosis associated with .

, which occurs as part of the oral microflora, is an uncommon cause of infection. However, it can cause serious bloodstream infections including infective endocarditis. Although oral bacteria, most commonly the spp, can cause internal jugular vein (IJV) thrombophlebitis, there are no reported cases of IJV thrombosis caused Here we report a patient with septic IJV thrombosis with bacteraemia.

Miliary cerebrospinal lesions caused by Nocardia beijingensis in an immunocompetent patient.

The genus usually infect immunocompromised patients. Pulmonary nocardiosis is the most common -induced infection while central nervous system (CNS) is the most common extrapulmonary site to develop nocardial disease. Approximately 54 % cases of previously reported nocardial brain abscesses were solitary lesions, while 38 % cases had multiple lesions; but miliary-like ring enhancing lesions have not been reported previously.

A Case of Anti-Glomerular Basement Membrane Glomerulonephritis Complicated by Type 1 Diabetes Mellitus, Mimicking Urinary Tract Infection.

BACKGROUND Type 1 diabetes mellitus (DM) tends to complicate other autoimmune diseases. When considering renal dysfunction in patients with DM, diabetic nephropathy is a likely diagnosis. By contrast, anti-glomerular basement membrane (GBM) glomerulonephritis, an autoimmune disease, is one cause of rapidly progressive glomerulonephritis.

[Hydrocephalus Mimicking Idiopathic Normal Pressure Hydrocephalus as the First Manifestation of Neurosarcoidosis].

A 61-year-old woman presented with a 10-month history of gait disturbance and a 7-month history of urinary incontinence. The Hasegawa dementia scale-revised score indicated cognitive impairment. Brain magnetic resonance imaging (MRI) indicated hydrocephalus with disproportionately enlarged subarachnoid space.

The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014.

Cardiac arrest caused by landiolol in a patient in thyroid crisis.

In the acute phase of a thyroid crisis, the cardiovascular mortality rate is high and the likelihood of death and severity of heart failure increase significantly with an increasing heart rate. Thus, heart rate control is essential to avoid cardiac death. Propranolol has been used to manage thyroid crisis, but worsening heart failure and cardiac arrest have been previously reported when using propranolol in such cases.

Eosinopenia as a Predictive Factor of the Short-Term Risk of Mortality and Infection after Acute Cerebral Infarction.

Background: Eosinopenia has been shown to be a prognostic factor in bacteremia, chronic obstructive pulmonary disease, and myocardial infarction, but studies focusing on cerebral infarction are lacking.

Methods: We conducted a retrospective study of 405 patients admitted to the Asahi General Hospital from June 2011 to September 2014 with a diagnosis of cerebral infarction within 24 hours after symptom onset. Differences in mortality, mortality associated with infection, and the prevalence of infection within 2 months of hospital admission were assessed between patients with and without eosinopenia at presentation.

Impact of inpatient caseload, emergency department duties, and online learning resource on General Medicine In-Training Examination scores in Japan.

Background: Both clinical workload and access to learning resource are important components of educational environment and may have effects on clinical knowledge of residents.

Methods: We conducted a survey with a clinical knowledge evaluation involving postgraduate year (PGY)-1 and -2 resident physicians at teaching hospitals offering 2-year postgraduate training programs required for residents in Japan, using the General Medicine In-Training Examination (GM-ITE). An individual-level analysis was conducted to examine the impact of the number of assigned patients and emergency department (ED) duty on the residents' GM-ITE scores by fitting a multivariable generalized estimating equations.

The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan.

Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven.

Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals.

Methods: To assess the knowledge base of medicine, we conducted the General Medicine InTraining Examination (GM-ITE) for second-year residents in the last month of their residency.