Systemic Amyloid Light Chain Amyloidosis With Repeated Syncope Due to Severe Orthostatic Hypotension Caused by Autonomic Neuropathy: A Case Report.

Amyloid light chain (AL) amyloidosis is a disease in which ALs, which are proteins with fibrous structures, are deposited in systemic organs, causing functional impairment. Diagnosis is often difficult because of non-specific and varied symptoms. We report a case of systemic AL amyloidosis that was diagnosed as a result of repeated syncope.

Type I Kounis syndrome in a young woman without chest pain: a case report.

Background: Kounis syndrome is defined as the concurrence of acute coronary syndromes in the setting of allergic or anaphylactic reactions. It primarily affects men aged 40-70 years and is often associated with chest pain. This syndrome is often unrecognized and undiagnosed in clinical practice due to a low level of awareness.

Assessing the medium-term effects of a community-based medical education program with homestay practice: a cohort study in Tamba, Japan.

Introduction: This study intended to evaluate the medium-term effectiveness of a community-based medical education (CBME) program and to determine the program's influence on the application rates of regional-quota students seeking to become residents in Tamba, Japan.

Materials And Methods: We conducted a cohort study of regional-quota students. Exposure factors included (1) experience compared to no experience of CBME in the Tamba area; (2) CBME experience compared to no experience in Tamba in the senior years (4-6 years of medical school) and experience in the junior years (1-3 years of medical school); and (3) experience in the senior years compared with those in the junior years.

Bacteremia caused by Desulfovibrio desulfuricans with the intestinal tract as the portal of entry: two case reports and a literature review.

Background: Desulfovibrio desulfuricans (D. desulfuricans), a commensal anaerobic gram-negative rod endemic to the soil environment and human gastrointestinal tract, rarely causes bloodstream infections. We report two rare cases of bacteremia caused by D.

Scalp vein sign caused by intracranial dural arteriovenous fistula.

A 68-year-old man presented with a headache that had started 1 month earlier. The scalp vein dilatation was observed at presentation. The findings of computed tomography and magnetic resonance imaging raised suspicion of a dural arteriovenous fistula, leading to the definitive diagnosis by digital subtraction angiography.

Antimicrobial-associated encephalopathy due to ampicillin.

Because the β-lactam ring has a molecular structure similar to that of gamma-aminobutyric acid (GABA) neurotransmitters, it binds to GABA A receptors and inhibits GABAergic transmission, causing AAE. The possibility of antimicrobial-associated encephalopathy should be considered in cases of neurological or psychiatric symptoms after initiating an antimicrobial regimen.

Effectiveness of remimazolam in preventing postoperative delirium in elderly patients with proximal femoral fractures.

Purpose: Elderly patients with proximal femoral fractures are known to be a high-risk group for postoperative delirium (POD). The aim of this study was to determine the association of the benzodiazepine drug remimazolam with POD in elderly patients with proximal femoral fractures.

Methods: In this single-center retrospective observational study, we included patients aged 65 years or older who underwent general anesthesia for proximal femoral fractures.

Temporal progression of pancreatic cancer computed tomography findings until diagnosis: A large-scale multicenter study.

Background: Focal parenchymal atrophy and main pancreatic duct (MPD) dilatation have been identified as early signs of pancreatic ductal adenocarcinoma. However, limited evidence exists regarding their temporal progression due to previous study limitations with restricted case numbers.

Objective: To ascertain a more precise frequency assessment of suspicious pancreatic ductal adenocarcinoma findings as well as delineate the temporal progression of them.

Brown crusts on infant owing to contact dermatitis associated with ethanol disinfection.

A 2-year-old girl developed dermatitis with atypical brown crusts after ethanol disinfection. Since many Oriental people have genetically reduced acetaldehyde dehydrogenase type 2 (ALDH2) activity, ethanol disinfection causes acetaldehyde to accumulate in the skin, resulting in dermatitis.

Pyogenic Spondylitis Caused by Parvimonas micra: A Case Report.

 () is a gram-positive anaerobic coccus endemic to the oral cavity and intestinal tract. We report a case of pyogenic spondylitis caused by and summarize the clinical features of previous case reports. An 81-year-old man with a history of lumbar vertebral compression fracture two years previously presented to the emergency department with low back pain.

Dengue Fever Complicated with Hemophagocytic Lymphohistiocytosis: A Case Report of Resolution with Steroid-Sparing Supportive Care.

Dengue fever (DF) can be complicated by hemophagocytic lymphohistiocytosis (HLH). Steroid administration is markedly effective for this hematologic complication, and for other viral infections. We present a rare case of DF-associated HLH that improved with steroid-sparing supportive care.

Steroid initiation timing and outcome of coronavirus disease 2019 patients: A multicenter, retrospective, observational study.

: Dexamethasone's (DEXA) beneficial effect on survival when administered to critically ill patients with coronavirus disease 2019 (COVID-19) has been documented in randomized trials and meta-analyses. Here, we conducted this study to clarify the association between time from COVID-19 onset to steroid initiation and mortality and to examine the factors underlying these results.: This was a multicenter, retrospective, observational study of patients enrolled in the Japanese COVID-19 Registry from January 1, 2020, to April 30, 2021.

Training items for trainee residents in community medicine in rural areas.

Objective: To examine the significant events experienced by initial trainees during community medicine training, evaluate their impact on community medicine practice, and support improvements in rural community medicine training.

Results: Three faculty teachers independently evaluated the reports of 25 residents who had completed a four-week community medicine training in a rural area to analyze major events. The reports were analyzed using topics from the Model Core Curriculum for Medical Education that relate to rural medicine.

Recurrence of unilateral angioedema of the tongue: A case report.

Background: Angioedema is a disorder characterized by edema of the face, lips, tongue, and extremities due to increased vascular permeability. Angioedema of the tongue usually occurs bilaterally, and the incidence of unilateral angioedema of the tongue is rare. This study reports a rare case of unilateral angioedema of the tongue with no identifiable cause and repeated recurrence even after discontinuation of an angiotensin-converting enzyme inhibitor.

The Immunology of Takotsubo Syndrome.

Takotsubo syndrome (TTS) is a disorder characterized by transient cardiac dysfunction with ventricular regional wall motion abnormalities, primarily thought to be caused by the effects of a sudden catecholamine surge on the heart. Although the majority of patients exhibit prompt recovery of their cardiac dysfunction, TTS remains associated with increased mortality rates acutely and at long-term, and there is currently no cure for TTS. Inflammation has been shown to play a key role in determining outcomes in TTS patients, as well as in the early pathogenesis of the disorder.

Drug-induced interstitial lung disease after chemoimmunotherapy for extensive-stage small cell lung cancer.

Objectives: The combination of chemotherapy and immune checkpoint inhibitors (chemo-ICI) has become the new standard of treatment for extensive-stage small cell lung cancer (ES-SCLC). Recently, slight changes in interstitial shadows, defined as interstitial lung abnormalities (ILA), have been identified. In patients with ES-SCLC who received chemo-ICI, there are limited data on the incidence of drug-induced interstitial lung disease (D-ILD) in daily practice and the association between the development of D-ILD and ILA in the baseline computed tomography (CT).

Long-term Survival after Treatment of Synchronous Isolated Right External Iliac Lymph Node Metastasis from Ascending Colon Cancer: A Case Report.

Background: Synchronous isolated external iliac lymph node metastasis of ascending colon cancer is extremely rare, and its treatment strategy has not been established. In this report, we present a case of long-term survival after surgical resection and adjuvant chemotherapy for ascending colon cancer with synchronous isolated right external iliac lymph node metastasis.

Clinical Case: A 65-year-old woman with anorexia and anemia was referred to our hospital.