Effectiveness of the educational training program for Japanese chief residents: A one-year pilot study.

Background: Multi-institutional faculty development programs for chief residents were lacking in Japan. This study evaluated the effectiveness of the program for enhancing the knowledge and behaviors of chief residents at the national level.

Methods: Six participants completed self-assessment questionnaires at three points: before, immediately after, and 6 months post-program.

A trial of structured debate as a self-learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan.

The structured debate as a means of medical education for medical students and young healthcare providers was performed, with diverse topics related to general and family medicine.

Benign adrenal cyst: A rare type of adrenal incidentaloma.

We present a patient with hypertension who developed a rare type of incidentaloma, a benign adrenal cyst. Benign adrenal cysts are typically large; however, most are nonfunctioning and asymptomatic, and they can be managed conservatively.

Penile cavernosal abscess after urethral injury.

We present a patient catheterized for prostatic lesions who developed sepsis of urinary origin with a penile cavernosal abscess due to urethral injury caused by catheter ballooning. Urethral injury might lead to a life-threatening penile abscess.

Task shifting of medical office works: A preliminary questionnaire survey for generalists.

To reduce physician burden, task shifting of clerical work from physicians to medical assistants is being promoted; however, it depends on hospitals. A questionnaire survey was conducted among 40 general physicians at Okayama University Hospital in December 2022 to investigate physicians' preferences toward task shifting. Compared to other tasks, most physicians thought that ordering examinations (14, 47%), replying to referral letters (19, 63%), and prescriptions (21, 70%) and medical record entries (22, 73%) should not be task shifted.

Preoperative detection of functional somatostatin receptors in a patient with an insulinoma.

Octreotide is used in patients with insulinomas to treat hypoglycemia, and somatostatin receptor (SSTR) 2 expression is important for its efficacy. We report a case of insulinoma in a 50-year-old woman that responded to an octreotide test, showed accumulation in somatostatin scintigraphy, and was positive for SSTR2A on immunostaining.

Furious lung abscess due to .

commonly present in the oral cavity and intestinal tract of humans. indicating a high virulence, has the potential of forming abscess. The infection of may require surgical excision.

Like a shot-through manubrium: A rare presentation of skeletal tuberculosis.

A 22-year-old Vietnamese woman presented with anterior chest swelling. Computed tomography revealed an osteolytic lesion in the manubrium, whereas MRI showed an extra-osseous expansion. A needle biopsy showed granuloma formation, whereas a 3-week mycobacterial culture indicated infection.

Five strategies on writing research papers for beginners and young general medicine doctors.

We propose five important strategies for young generalists to write original research and papers. We hope that even beginners will understand and practice these five strategies, and help young generalist to write research papers based on clinical questions that arise in their daily practice.

Tuberculous meningitis.

Tuberculous meningitis is possibly complicated with multiple cerebral infarctions and basal meningitis, and the mortality and neurological prognosis is reportedly poor. This case suggested that clinicians should consider tuberculous meningitis as a differential diagnosis of patients with disturbed consciousness in an aging country Japan.

Key signs indicating mesenteric panniculitis.

Since patients with mesenteric panniculitis (MP) present non-specific symptoms, diagnosing MP is challenging. We describe a 45-year-old man who developed MP with radiologic findings of a "fat ring sign" and a "tumoral pseudocapsule sign." These signs shown in the present case are crucial for a precise diagnosis of MP.

Rhinogenic optic neuropathy with hemianopia caused by ethmoidal sinus mucocele.

A patient complained of acute right vision loss and headache. A computed tomography scan revealed ethmoidal sinus mucocele in the right ethmoid sinus that was compressing the optic nerve and emergency endoscopic sinus surgery was performed.

Isolated unilateral absence of adult pulmonary artery.

Isolated unilateral absence of pulmonary artery (UAPA) is a rare congenital malformation. We describe a 26-year-old woman with isolated UAPA who presented with hemoptysis. Since massive hemoptysis may mandate selective embolization of collaterals or surgical treatment, early diagnosis of UAPA is pivotal.

Kikuchi-Fujimoto disease manifesting bilateral lymphadenopathy.

Physicians should keep in mind that Kikuchi-Fujimoto disease can show bilateral lymphadenopathy like the present case.

Global public awareness of Castleman disease and TAFRO syndrome between 2015 and 2021: A Google Trends analysis.

Castleman disease (CD) is a rare lymphoproliferative disorder with multiple subtypes. Thrombocytopenia, anasarca, fever, reticulin fibrosis or renal insufficiency, and organomegaly (TAFRO) syndrome can occur in the context of CD. The study evaluated worldwide public awareness of CD and TAFRO syndrome using Google Trends data between 2015 and 2021.

Primary bone lymphoma presenting as fever of unknown origin.

We presented a case of primary bone lymphoma (PBL) which demonstrated fever of unknown origin. Although the diagnosis of PBL is difficult, up to 11% of patients with fever of unknown origin were later diagnosed with PBL, which suggests that there may be many cases of misdiagnosis. This case study emphasizes the importance of careful diagnosis for fever of unknown origin especially when the patient has bone pain.

Inconsistency of the "Sogo-Shinryo" department in Japanese hospitals.

The inconsistency of Japanese names of "Sogo-Shinryo" departments is also a greater problem in this country, and we are afraid that it may cause anxiety to patients, residents, and students. As one of the "Sogo-Shinryo" departments in Japan, we want to provide them comprehensive learning environments regardless of the boundaries of academic cliques and societies, and, as a result, relieve them, foster general minds, and build their careers.

Cat scratch disease without a history of cat exposure.

A patient complaining of swelling and tenderness in her left axilla was diagnosed with cat scratch disease despite no apparent history of cat exposure. Zoonosis can occur even in the absence of cat exposure because cat flea is also the vector of the pathogen through the flea feces.

Subcutaneous edema as rare complication of abdominal paracentesis.

Although ascites leakage to the skin is the most frequent complication after abdominal paracentesis, leakage to the subcutaneous space has not been reported. Here, we report a subcutaneous effusion after paracentesis suggesting ascites leakage. We should be aware of this rare complication due to the potential risk of dissemination.

Emphysematous gastritis.

An 89-year-old woman who had type 2 diabetes mellitus suddenly presented with abdominal pain. Abdominal computed tomography showed thickening of the wall and intramural gas in the gastric hilum, suggesting emphysematous gastritis. The patient underwent treatment with a proton-pump inhibitor and broad-spectrum antibacterial agents.

Various perspectives of "General Medicine" in Japan-Respect for and cooperation with each other as the same "General Medicine Physicians".

In Japan, the general medicine category includes various specialties: "family physician," "hospitalist," and "hospital family physician." These specialties can be illustrated from two perspectives for an easy understanding of their characteristics.

Celiac artery dissection in polycystic kidney disease.

Autosomal-dominant polycystic kidney disease (ADPKD) is rarely complicated by celiac artery dissection. Dissection of the aorta and its major branches should be carefully differentiated in ADPKD patients with acute-onset abdominal pain.

Candidemia in COVID-19 treated with corticosteroids and tocilizumab.

COVID-19 patients treated with anti-inflammatory drugs are rarely complicated by candidemia. Since immunosuppressive therapy can blunt inflammatory reactions, clinicians should actively survey latent candidemia during severe COVID-19 treatment.

Pseudoacromegaly with acromegalic features in radiography.

Pseudoacromegaly is a condition characterized by acromegalic physical features without growth hormone excess, for which radiographic observation has seldom been reported. This is a rare case of pseudoacromegaly.