Hepatic Encephalopathy Without Hyperammonemia in the Setting of Liver Metastases by a Pancreatic Neuroendocrine Tumor.

Hepatic encephalopathy (HE) is a neurological impairment that typically occurs in patients with liver dysfunction or portosystemic shunting. Diagnosing HE can be challenging since it requires a process of exclusion. Ammonia is considered a major contributor to HE, though ruling out HE solely based on ammonia levels has the potential for misdiagnosis.

Retrospective analysis of urinary tract infections in long-term care facilities in Japan: Insights from physical examination-based diagnosis.

Objectives: Multidrug-resistant (MDR) bacterial infections are highly prevalent among long-term care facility (LTCF) residents, and are thus important targets for antimicrobial stewardship. Diagnoses of urinary tract infections (UTIs), which are associated with antimicrobial use in these facilities, are not always made by physicians. Past epidemiologic studies have included asymptomatic bacteriuria together with UTIs.

Extrapulmonary pneumocystosis in an antiretroviral therapy-naïve, HIV-positive patient.

Pneumocystis jirovecii is a common opportunistic fungal pathogen that commonly affects immunocompromised individuals and can cause P. jirovecii pneumonia. Extrapulmonary P.

＜Editors' Choice＞ Developing online lectures using text mining reduces health workers' anxiety in non-epicenter areas of COVID-19.

COVID-19 is indirectly associated with various mental disorders such as anxiety, insomnia, and depression, and healthcare professionals who treat COVID-19 patients are particularly prone to severe anxiety. However, neither the anxiety of healthcare workers in non-epicenter areas nor the effects of knowledge support have been examined thus far. Participants were 458 staff working at the Toyota Regional Medical Center who completed a preliminary questionnaire of their knowledge and anxiety regarding COVID-19.

Clinical Prognosis of Patients With Mild COVID-19 Treated With Casirivimab/Imdevimab in Japan.

Aim: This study aimed to report clinical courses of patients who had mild coronavirus disease 2019 (COVID-19), defined as SpO of 96 or higher, and treated with/without casirivimab/imdevimab in Japan, where mortality and number of severe patients were very limited compared to other resource-rich countries.

Methods: We conducted a retrospective cohort study in Toyota Regional Medical Center, Toyota, Japan, from August 31, 2021, to September 27, 2021. We included all patients with COVID-19 who were diagnosed at the hospital's family medicine department.

Association Between Antidiarrheal Drug Prescription and Return Visits Among Adult Patients With Acute Diarrhea.

Whether antidiarrheal medications have benefits or demerits when administered to adult patients with diarrhea remains controversial. We aimed to evaluate the association between antidiarrheal drug prescription and clinical outcomes in adult patients with acute diarrhea. This retrospective cohort study was conducted by collecting secondary data of patients' health records at St.

Transient global amnesia with bilateral hippocampal lesions during the COVID-19 global outbreak.

This manuscript presents a case report of transient global amnesia with bilateral hippocampal lesions which might be triggered by the fear of getting infected by coronavirus disease 2019 (COVID-19). The purpose of this article is to facilitate the clinicians in understanding that an increasing number of patients with transient global amnesia have been reported during the COVID-19 global outbreak.

Factors associated with the accomplishment of home death among patients receiving physician-led home healthcare.

Aim: To evaluate unique factors associated with home death in older Asian individuals who received physician-led home healthcare.

Methods: We carried out a case-control study at a single hospital in Japan from February 2018 to December 2019. We included patients who had started receiving physician-led home healthcare and died at home as cases, and those receiving the same type of care but died in the hospital as controls.

Neurofibromatosis type 1 with subarachnoid haemorrhage from the left vertebral arteriovenous fistula: case presentation and literature review.

We present the case of a 47-year-old woman with neurofibromatosis type 1 (NF1) with subarachnoid haemorrhage (SAH) from the left vertebral arteriovenous fistula, along with a review of previous cases. Our patient had a family history of NF1 and presented to the emergency department with a sudden-onset severe headache and neck pain. CT scan showed SAH.

Direct and indirect costs of home healthcare in Japan: A cross-sectional study.

To tackle the rising healthcare expenditure in an ageing society in Japan, home healthcare has been promoted over the past several years. However, there is a dearth of literature on total costs incurring for home healthcare. In this study, we conducted a cross-sectional study among patients, who received home healthcare in the month of May, 2018.

Effect of continuation of antiplatelet therapy on survival in patients receiving physician home visits.

Background: Little is known about the effects of continued antiplatelet therapy in patients who receive physician home visits. This study aimed to evaluate the association of survival with the continuation of antiplatelet drugs in patients who received physician home visits.

Methods: A retrospective cohort study was conducted in a teaching hospital in Toyota, Japan, from April 2015 to October 2018.

Repeated measures of extremely high levels of high-density lipoprotein cholesterol and subsequent all-cause mortality and cardiovascular events: A longitudinal study.

Background And Aims: Extremely high level high-density lipoprotein (HDL) cholesterol had been cautioned as risk factor for all-cause mortality and cardiovascular disease. However, both the physician and the patient may underestimate the risk due to the emphasis on "good cholesterol", resulting in passive treatment or adoption of a less healthy lifestyle. The aim of this study is to re-evaluate the association with longitudinal data to account for fluctuations in HDL cholesterol and covariates.

Alcohol consumption behaviours in the immediate aftermath of earthquakes: time series study.

Objectives: Earthquakes are a distressing natural phenomenon that can disrupt normal health-related behaviours. The aim of this study was to investigate changes in alcohol consumption behaviours in the immediate aftermath of mild to moderate earthquakes.

Setting: This retrospective cohort study was conducted at a large academic hospital in Tokyo, Japan from April 2004 to March 2017.

Incidence of cardiovascular events in polymyalgia rheumatica and giant cell arteritis amongst an Asian population: Propensity score matched cohort study.

Background: The hypothesis that patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) have a high risk for future cardiovascular diseases has not been adequately tested. The aim of this study is to evaluate this hypothesis in Japan, where the prevalence and severity of PMR and GCA are the lowest.

Methods: A propensity score matched cohort study was conducted at St.

Longitudinal relationships between cardiovascular events, risk factors, and time-dependent sleep duration.

Background: Although many studies have evaluated the relationships between sleep duration and cardiovascular (CV) events/risk factors, longitudinal associations with time-dependent sleep duration have not been adequately assessed.

Methods: A retrospective, longitudinal study was conducted involving individuals aged 20 years or older that received annual health check-ups at St. Luke's International Hospital from 2005 to 2010.

Cost of physician-led home visit care (Zaitaku care) compared with hospital care at the end of life in Japan.

Background: Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied.

Adult-onset Still's disease complicated by autoimmune hepatitis: successful treatment with infliximab.

A 17-year-old woman was previously diagnosed with autoimmune hepatitis (AIH) by liver biopsy. Adult-onset Still's disease (AOSD) was subsequently diagnosed on the basis of high fever, arthralgia, erythema, leukocytosis (>80% granulocytes), cervical lymph node swelling, splenomegaly, and hyperferritinemia. Her symptoms and liver dysfunction improved with prednisolone of 60 mg daily and subsequently methotrexate was added.

A concomitant case of giant cell arteritis and microscopic polyangiitis with hemoperitoneum by rupture of the gastroepiploic artery.

Giant cell arteritis (GCA) mainly involves large-sized arteries, while microscopic polyangiitis (mPA), characterized by pauci-immune necrotizing vasculitis, mainly affects small-sized vessels. We report a very rare concomitant case of GCA diagnosed by temporal artery biopsy and mPA with a high titer of myeloperoxidase antineutrophil cytoplasmic antibody, exacerbation of interstitial pneumonia, and suspected rapidly progressive glomerulonephritis. The patient died by sudden rupture of the gastroepiploic artery (medium-sized vessel), which may have been triggered by GCA and/or mPA.