Perceptions of C-reactive Protein Measurement Among General Physicians: A Qualitative Study on Diagnostic Value, Clinical Dilemmas, and Professional Growth.

Introduction C-reactive protein (CRP) is a widely used laboratory test for assessing infections, inflammatory diseases, and malignancies, playing a critical role in clinical diagnosis and management. Despite its utility, CRP measurement practices vary among physicians, often influenced by training and clinical experience. This study explores general physicians' perceptions of CRP measurement in clinical practice, focusing on its diagnostic value, associated dilemmas, and impact on clinical growth and decision-making.

Extended Follow-Up and Analysis of Non-secretory IgG-Type Multiple Myeloma in a Patient With Fibromyalgia: A Case Report.

Fibromyalgia (FM) presents a diagnostic challenge due to its complex symptoms and lack of definitive tests. This study discusses a 54-year-old female initially diagnosed with FM, characterized by widespread pain, fatigue, and tender points. Despite treatment, she developed elevated C-reactive protein (CRP) and anemia after two years, leading to further investigations.

The Association Between the Frequency of Agriculture and Control of Chronic Diseases Among Regular Patients in Rural Community Hospitals: A Cross-Sectional Study.

Introduction The importance of exercise in chronic disease management among older people is paramount, especially as the global population ages and the prevalence of chronic diseases such as cardiovascular disease, diabetes, and arthritis increases. Regular physical activity enhances cardiovascular health, improves metabolic function, and alleviates symptoms of musculoskeletal disorders. As a form of exercise, agriculture provides physical and mental benefits for older adults.

A Case of Mammary-Type Myofibroblastoma Occurring in the Inguinal Region.

Mammary-type myofibroblastoma (MTMF) is a rare benign tumor of mesenchymal cells that occurs in the inguinal region, abdominal wall, buttocks, back, and vaginal wall. When a soft tissue mass develops in the inguinal region, there may be a risk of misdiagnosing it as an inguinal hernia, especially if it is asymptomatic. We report a rare case of mammary-type myofibroblastoma occurring in the inguinal region.

Chronic and Acute Drug-Induced Hypersensitivity Syndrome in a Rural Patient With Cytomegalovirus Infection: A Case Report.

A 50-year-old man presented with fever and a generalized rash, with chronic fatigue and lymphadenopathy for a year and a half. Initial tests ruled out lymphoproliferative disorders, showing reactive hyperplasia and cytomegalovirus. Symptoms worsened after ampicillin treatment, leading to suspected drug-induced hypersensitivity syndrome (DIHS).

Anti-neutrophil Cytoplasmic Antibody-Negative Rapid Progressive Glomerulonephritis With Mild Pathological Presentation in an Older Patient: A Case Report.

This case report discusses the management of anti-neutrophil cytoplasmic antibodies (ANCA)-negative rapid progressive glomerulonephritis (RPGN) in a 68-year-old man with a complex medical history, presenting with fatigue, edema, and acute renal failure. Despite the absence of positive biomarkers for specific RPGN types, the clinical progression suggested microscopic polyangiitis, leading to intensive immunosuppressive therapy with cyclophosphamide and rituximab. The patient's condition was further complicated by the coexistence of nephritic and nephrotic syndromes, requiring nuanced management strategies, including prolonged hemodialysis.

Giant Cell Arteritis With Sepsis-Like Symptoms in an Elderly Man: A Case Report.

This case report details the diagnostic challenge and management of an 88-year-old man who presented to a rural Japanese community hospital with sepsis-like symptoms, initially suspected of acute bacterial cholangitis based on his physical and laboratory findings. Despite the antibiotic treatment of tazobactam and piperacillin, the patient's symptoms persisted, leading to further investigations that revealed no signs of infection but notable aortic arch wall thickening on contrast-enhanced computed tomography scans. These findings, combined with the patient's clinical presentation and lack of antibiotic response, redirected the diagnosis toward giant cell arteritis (GCA).

Disparity of the Treatment of Unresectable Non-small Cell Lung Cancer Regarding Chemotherapy: A Systematic Review and Meta-Analysis.

This study investigates disparities in chemotherapy treatment for unresectable non-small cell lung cancer (NSCLC) between urban and rural populations. Despite advancements in NSCLC treatments enhancing survival, significant inequities persist, notably in rural areas where access to care is often limited, resulting in poorer outcomes. Through a systematic review and meta-analysis, we analyzed data from selected studies that compare chemotherapy access and usage between these populations from 2010 to 2024.

Family Medicine Implementation to Maternal and Child Health in Rural Japan: A Narrative Review.

This research provides a critical narrative review of maternal and child health (MCH) in rural Japan, reflecting broader challenges faced by aging societies globally. The study explores the intertwined roles of professional and lay care in sustaining rural communities, emphasizing the unique position of family medicine and primary care in enhancing MCH services. The scarcity of healthcare resources, particularly the shortage of obstetricians and the weakening of traditional community support systems, underscores the challenges in these areas.

Linking Agricultural Activity Frequency to Loneliness in Rural Hospital Patients: A Cross-Sectional Study.

Introduction Agriculture is deeply woven into the fabric of rural life, influencing the economy, and the social and health dynamics of rural communities. While it offers physical and mental health benefits through regular physical activity and interaction with nature, the solitary nature of farming activities may also lead to social isolation. This study explores the complex relationship between the frequency of agricultural engagement and feelings of loneliness among rural inhabitants with chronic diseases, addressing a gap in the literature concerning the impact of agricultural practices on social well-being.

Impact of COVID-19 pandemic on the dynamic of patients with oral and maxillofacial trauma: interrupted time-series analysis.

Oral and maxillofacial trauma is influenced by various factors, including regional characteristics and social background. Due to the coronavirus disease 2019 (COVID-19) pandemic, a state of emergency was declared in Japan in March 2020. In this study, we aimed to examine the dynamics of patients with oral and maxillofacial trauma over a 12-years period using interrupted time-series (ITS) analysis.

A Case Report of Remitting Seronegative Symmetrical Synovitis With Pitting Edema Causing Severe Anemia, Acute Progressive Dementia, and Chronic Eczema in an Older Female.

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is a type of seronegative arthritis characterized by a favorable prognosis (Remitting), absence of rheumatoid factor (Seronegative), symmetry (Symmetrical), and synovitis with pitting edema on the backs of the hands and feet. The cause of RS3PE syndrome remains unknown, but involvement of the immune system is suspected, and steroids are highly effective. Here, we present a case of an 86-year-old woman with severe anemia and bilateral lower limb edema accompanied by chronic eczema, considered to be caused by RS3PE syndrome.

Drug-Induced Hypersensitivity Syndrome Due to Long-Term Usage of Methotrexate: A Case Report.

Methotrexate (MTX), a cornerstone treatment for rheumatoid arthritis (RA), is associated with drug-induced hypersensitivity syndrome (DIHS), including rare instances of methotrexate-induced pneumonitis. We report a significant case of a 65-year-old woman with RA, treated with MTX for over two decades, who presented with fever, headache, nausea, and malaise and was later diagnosed with DIHS, manifesting as pneumonitis and hepatosplenomegaly. Despite initial suspicion of bacterial pneumonia, her condition deteriorated, leading to the consideration of DIHS.

The Association Between Community Dialogue and Loneliness in Rural Japanese Communities: A Cross-Sectional Study.

Introduction This investigation explores the influence of community dialogue on loneliness within rural Japanese communities amidst the backdrop of globalization, urbanization, and technological shifts. Highlighting the significance of both informal and formal community dialogues, the study aims to bridge the gap in empirical evidence regarding the role of these interactions in enhancing social cohesion and mitigating loneliness, particularly in rural areas facing demographic changes and privacy concerns. Method A cross-sectional study was performed in Unnan City, Japan, targeting individuals over 40 who regularly visited a local rural hospital.

Differentiation Between Disseminated Carcinomatosis of the Bone Marrow From Urothelial Cancer and Intravascular Large B-cell Lymphoma: A Case Report.

This case report describes a rare case of intravascular large B-cell lymphoma (IVLBCL), initially presenting with nonspecific symptoms of fever and fatigue, and tentatively diagnosed as disseminated carcinomatosis of the bone marrow originating from urothelial cancer in an 80-year-old woman. The patient's journey began with symptoms treated as common ailments and progressed through multiple differential diagnoses, including giant cell arteritis, TAFRO (thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly) syndrome, and disseminated carcinomatosis of the bone marrow originating from urothelial cancer due to the presence of systemic inflammation, anasarca, and elevated soluble interleukin 2 receptor levels, indicative of an intense immunological response. Despite initial treatments, her condition deteriorated, leading to further investigations that ultimately revealed the presence of malignant cells in the urine and bone marrow, confirming the diagnosis of IVLBCL.

Applying Advanced Practice Nurses in Rural Japan: A Mixed-Methods Perspective.

Introduction Rural hospitals, particularly those in geographically isolated regions like Shimane Prefecture, Japan, face significant healthcare delivery challenges. These include limited resources, an aging population, and a scarcity of healthcare professionals. Advanced practice nurses (APNs) have emerged as pivotal in addressing these gaps, offering specialized patient assessment, diagnosis, and management skills.

Association between and Mutations and Progesterone Resistance in Endometriotic Epithelial Cell Line.

Although endometriosis is a benign disease, it is associated with cancer-related gene mutations, such as or . Endometriosis is associated with elevated levels of inflammatory factors that cause severe pain. In a previous study, we demonstrated that or mutations are associated with the activation of cell proliferation, migration, and invasion in a patient-derived immortalized endometriotic cell line, HMOsisEC10.

The Balance Between Intensive and Palliative Care in an Anti-melanoma Differentiation-Associated Gene 5 (MDA5) Antibody-Positive Acute Interstitial Pneumonia in a Nonagenarian: A Case Report.

This case report details the management of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive acute interstitial pneumonia in a 93-year-old man, a condition characterized by rapid progression and high mortality. Despite the grim prognosis typically associated with this disease, especially in elderly patients, the subject of this report survived beyond the expected timeframe, illustrating the effectiveness of prompt and aggressive treatment strategies. Initially presenting with dyspnea, the patient's diagnostic process was challenging due to the absence of dermatomyositis (DM)-specific skin manifestations.

Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach.

Background: Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients.

The Association Between Community Participation and Loneliness Among Patients in Rural Community Hospitals: A Cross-Sectional Study.

Introduction Loneliness among adults is a critical public health issue, particularly in rural areas where social isolation can be more pronounced. Understanding the factors that influence loneliness can guide the development of effective interventions. This study explores the impact of demographic, health-related, and social participation factors on loneliness among rural Japanese adults, focusing on the role of community participation.