The patient was a 64-year-old woman with a nearly 20-year history of sicca symptoms, having been given a diagnosis of primary Sjögren's syndrome. Three years previously, she experienced difficulty in walking up a slope and had leg malaise, which insidiously progressed to an inability to go up and down stairs. This disability brought her to our hospital, where her muscle strength was examined by manual muscle testing, and she was found to have reduced muscle strength in proximal muscles like the thigh muscles and the neck flexor muscles. Blood studies revealed elevated ESR, increased serum IgG, mildly increased myogenic enzymes, and positive results for anti-SS-A and -SS-B antibodies. MRI scans disclosed extensive muscle atrophy as well as fatty degeneration in the thigh. A biopsy of the quadriceps femoris muscle provided a diagnosis of myositis based on the finding of muscle fibers of unequal size, nuclear centralization, and inflammatory cell infiltration into muscle fibers. CD4-positive lymphocytes were the predominant inflammatory cells. We diagnosed the case as myositis in primary Sjögren's syndrome based on the clinical course and laboratory findings. She recovered well with steroid medication. It is noteworthy that myositis associated with primary Sjögren's syndrome presents with mild symptoms and unremarkable laboratory data but may run a chronic progressive course.
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http://dx.doi.org/10.2177/jsci.33.277 | DOI Listing |
Curr Opin Otolaryngol Head Neck Surg
December 2024
Purpose Of Review: To summarize current evidence regarding the indication of adjuvant treatment after transoral laser microsurgery (TOLMS).
Recent Findings: Apart from well known risk factors, margins represent the key point in the decision-making. If margins are affected, additional treatment is mandatory.
JMIR Pediatr Parent
January 2025
General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: Mental health problems among adolescents are increasing, and internet-delivered acceptance and commitment therapy (iACT) constitutes a possible way to improve access to care while reducing costs. Nevertheless, few studies have investigated iACT for adolescents in regular primary care nor the role of parental support.
Objective: This is an exploratory evaluation investigating iACT, with or without parental support, for adolescents.
JMIR Res Protoc
January 2025
Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Background: Psychotherapy is central to the treatment of mental disorders, highlighting the importance of medical students and residents developing competencies in this area. Chinese medical residents have expressed a strong need for psychotherapy training, yet they are generally dissatisfied with the current offerings. This paper presents the protocol for an evidence-based, well-structured psychotherapy teaching program aimed at medical students and residents.
View Article and Find Full Text PDFJAMA Health Forum
January 2025
Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.
Importance: 2021 Advance child tax credit (ACTC) monthly payments were associated with reduced US child poverty rates; however, policymakers have expressed concerns that permanent adoption would increase parental substance use.
Objective: To assess whether 2021 ACTC monthly payments were temporally associated with changes in substance use among parents compared with adults without children.
Design, Setting, And Participants: The primary sample included adults aged 18 to 64 years who responded to the National Survey on Drug Use and Health in 2021.
JAMA Netw Open
January 2025
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Importance: Administrative health data serve as promising data sources to study transgender health at a population level in the absence of self-reported gender identity.
Objective: To develop and validate case definitions identifying transgender adults in administrative data compared with the reference standard of self-reported gender identity in a universal health care setting.
Design, Setting, And Participants: In this cohort study conducted in Alberta, Canada, data from provincial administrative health data sources including inpatient hospitalizations, emergency department encounters, primary care visits, prescription drug dispensations, and the provincial health insurance registry were linked and used to develop 15 case definitions (9 for transgender women and 6 for transgender men).
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