Reflection in Rural Family Medicine Education.

Reflection in medical education is vital for students' development as professionals. The lack of medical educators in rural family medicine can impinge on the effective reflection of residents' learning. Hence, based on qualitative research, we proposed a framework regarding reflection in rural family medicine education, indicating when, where, and how reflection is performed and progresses.

Factors Associated with Motivation for General Medicine among Rural Medical Students: A Cross-Sectional Study.

General medicine, as the Japanese version of primary care or family medicine, is critical for healthcare in aging societies. Medical students' perceptions of general medicine and education might be associated with changes in the number of general physicians. This study aimed to clarify the association between these perceptions and students' preferences for general medicine.

A Solution for Loneliness in Rural Populations: The Effects of Osekkai Conferences during the COVID-19 Pandemic.

Social prescribing is an essential solution to the lack of social connection and interaction and provides a key approach to problems faced by communities during the COVID-19 pandemic. One social prescription used in Japan is the Osekkai conference, which has the potential to increase social participation in rural communities. The revitalization of Osekkai can improve social interactions among people involved in the conference, thereby reducing loneliness.

Yersinia pseudotuberculosis Bacteremia Complicated by Rhabdomyolysis.

is a rare pathogen that causes yersiniosis, a foodborne disease that has become more prevalent in recent years Yersiniosis commonly causes gastrointestinal symptoms; however, bacteremia can be the primary clinical finding. Here, we report the case of an 83-year-old man who presented with fever and fatigue and was diagnosed with bacteremia. Gastrointestinal findings were absent at the time of admission.

Successful Control of Hypercalcemia with Sorafenib, Evocalcet, and Denosumab Combination Therapy for Recurrent Parathyroid Carcinoma.

Parathyroid carcinoma (PC) is a rare type of endocrine cancer. Recurrence and metastasis are common after surgery, and refractory hypercalcemia often leads to a poor prognosis. However, there are currently no specific strategies for PC recurrence.

Serotonin Syndrome Triggered by Overuse of Caffeine and Complicated With Neuroleptic Malignant Syndrome: A Case Report.

Serotonin syndrome is a rare complication occurring in patients with psychiatric disorders that are treated with selective serotonin reuptake inhibitors (SSRIs). There are various triggers for serotonin syndrome, including non-SSRI antidepressants. In rare cases, serotonin syndrome may be triggered by nonmedicinal foods, such as coffee.

Older People's Help-Seeking Behaviors in Rural Contexts: A Systematic Review.

Help-seeking behavior (HSB) is vital for older people to sustain their health. As people in aging societies increasingly demand management of their multiple symptoms, communities should encourage HSBs. In rural communities, insufficient healthcare and human resources influence older people's health.

A Rare Case of Herpes Esophagitis in an Immunocompetent Elderly Patient.

Herpes esophagitis is common among immunocompromised hosts but is relatively rare among immunocompetent patients. Its symptoms are vague because many different symptoms can be induced by esophageal lesions. Here, we report a case of herpes esophagitis in an elderly immunocompetent patient.

Herpes Simplex Virus Pneumonia Mimicking Legionella Pneumonia in an Elderly Patient With Heart and Liver Failure.

The diagnosis of viral pneumonia is often difficult because of its varied presentations. Regarding the serological diagnosis of viral infections, it is difficult to perform a viral DNA test in general medical facilities, especially in rural settings. Among viral pneumonia cases, herpes simplex virus (HSV) pneumonia can occur in immunocompromised hosts.

Nurses' Contributions in Rural Family Medicine Education: A Mixed-Method Approach.

Family medicine residents frequently collaborate with nurses regarding clinical decisions and treatments, which contributes to their education. In rural areas, these residents experience a wider scope of practice by collaborating with nurses. However, nurses' contributions to rural family medicine education have not been clarified.

Sources of anxiety in young rural physicians working alone on remote islands: A qualitative study.

Background: We aimed to examine the sources of anxiety for young rural physicians working alone on remote islands.

Methods: Semistructured interviews were conducted on six physicians who worked on remote islands. The Steps for Coding and Theorization method was used to analyze the content of the interviews.

Difficulty in Diagnosing and Treating a Prostate Abscess With Bacterial and Fungal Coinfection in an Immunocompromised Patient.

Prostate abscesses often occur in immunocompromised individuals. Contrast-enhanced imaging tests can aid diagnosis; however, they can be difficult to perform in older patients with renal insufficiency. Various organisms can cause prostate abscesses, and poor antibiotic penetration into the prostate can hinder treatment.

Fatal Bleeding From a Common Iliac Arterio-Ureteral Fistula in an Older Patient.

Fatal ureteral bleeding is rare among elderly individuals. One cause of bleeding can be a fistula between the arteries and urinary organs, such as a common iliac arterio-ureteral fistula. However, the clinical presentation of fistulas can vary.

Pericarditis With Cardiac Tamponade Mimicking Yellow Nail Syndrome in a Patient With Rheumatoid Arthritis and a Paucity of Joint Symptoms.

Pericarditis is a cardiac disease that commonly manifests with rheumatoid arthritis, and its complications are related to rheumatoid arthritis disease activity. The diagnosis can be complicated in patients with multiple extra-joint complications of rheumatoid arthritis. We report a case of pericarditis in an 82-year-old woman with few joint symptoms who was admitted to the hospital due to worsening edema of the lower legs and dyspnea, which progressed to cardiac tamponade.

Surgical Interventions in Cases of Esophageal Hiatal Hernias among Older Japanese Adults: A Systematic Review.

: Given Japan's superaging population, an increasing number of older adults in the country need surgical treatment for esophageal hiatal hernias. Accordingly, this systematic review examines surgical interventions for symptomatic esophageal hiatal hernias in older Japanese patients and explores treatment outcomes. : Articles on single operations for hiatal hernias published after 1991 were found on Google Scholar and Ichushi using specific keywords.

Clinical Presentation and Mortality of Severe Fever with Thrombocytopenia Syndrome in Japan: A Systematic Review of Case Reports.

Severe fever with thrombocytopenia syndrome (SFTS) is an infection mediated by ticks and has been reported to have a high mortality rate in Japan. At our hospital, we reported three cases of SFTS with relatively positive outcomes. We reviewed reports of SFTS cases in Japan to clarify the current state of the disease in Japan, the treatment provided, and its outcome.

Intercostal Muscle Abscesses in Infective Endocarditis Associated With Migratory Deposition of Calcium Pyrophosphate.

Infective endocarditis (IE) is caused by vegetations, consisting of platelets, fibrin, inflammatory cells, and microcolonies of bacteria, fungi, rickettsia, chlamydia, and viruses, that form in the heart valves, endocardium, and large vessel intima.  endocarditis is highly tissue destructive, usually follows an acute course, and tends to become severe due to valve destruction, surrounding abscesses, and distant seeding. The main complications of IE due to  are heart failure due to destruction of tendon cords and valves, perivalvular abscesses and fistulas, and the dissemination of septic emboli to various organs including the brain, kidney, spleen, and lungs.

Severe Immune Thrombocytopenic Purpura Following Influenza Vaccination: A Case Report.

Immune thrombocytopenia (ITP) is a rare, acquired bleeding disorder caused by various underlying etiologies. ITP can be triggered by medication, infections, cancers, and autoimmune diseases. One of the rare triggers is vaccination.

The Persistent Approach to Diagnose Infectious Hepatic Cysts in a Patient With Recurrent Fever: A Case Report.

Diagnosing infectious hepatic cysts (IHCs) can be challenging. Moreover, patients with IHCs may present with various symptoms. Diagnosis of IHCs can be even more difficult in patients with multiple liver cysts.

Peritoneal Cancer Mimicking Sclerosing Mesenteritis: A Case Report.

Peritoneal cancer is a rare disease that typically affects middle-aged women. Sclerosing mesenteritis can have a benign or malignant etiology. Although computed tomography (CT) scan and magnetic resonance imaging have been used to differentiate these two diseases, the findings are not always conclusive.

Bilateral Intracardiac Microbubbles in a Patient With Giant Hiatus Hernia: A Case Report.

Intracardiac microbubbles may occur inadvertently during a cardiac procedure, which are typically reported in patients with central venous catheters or cardiac prosthetic valves. Here, we report a case wherein a microbubble filling in the bilateral atriums and ventricles was revealed during echocardiography despite the patient not having the aforementioned risks. An 87-year-old man with hypertension was admitted with a diagnosis of heart failure caused by a giant hiatal hernia.

Natural Killer T Cell Intravascular Lymphoma With Presentation of Musculoskeletal Pain: A Case Report.

Natural killer T cell intravascular lymphoma is a rare category of lymphoma among older individuals. The presentation of natural killer T cell lymphoma varies, causing diagnostic challenges for clinicians. Thus far, only a few studies have reported this condition in the context of musculoskeletal symptoms.