Remote Death Certification Using Telemedicine in Japan
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.6588-20. Online ahead of print.ABSTRACTA 92-year-old woman diagnosed with dementia and end-stage gastric cancer received end-of-life care on the island where she lived. Informed consent concerning remote death certification based on the Japanese government's guidelines was obtained from a family member in case a physician was unavailable. A physical examination after cardiopulmonary arrest was conducted, supported by telemedicine and a well-trained registered nurse under remote supervision of the physician who last saw the deceased directly. Death certification was pro...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Kemmyo Sugiyama Shintaro Yanaka Toshiaki Yasuda Takashi Watanabe Akira Yamashiro Junichi Narita Akio Tomoda Isamu Sohtome Source Type: research

Changes in the Mean Intrahepatic Target Computed Tomography Attenuation Value During Treatment May be a Useful New Predictor of the Post-progression Survival Associated with Lenvatinib Treatment
Conclusion A rate of decrease in attenuation ≥40% may reflect a good response of a highly malignant tumor to lenvatinib. Therefore, this value may have utility as a surrogate marker for estimating the oncological aggressiveness of tumors and their associated prognosis.PMID:34511564 | DOI:10.2169/internalmedicine.7589-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Nozomu Muraishi Yusuke Kawamura Masahiro Kobayashi Junichi Shindoh Yuta Kobayashi Satoshi Okubo Soichi Iritani Shunichiro Fujiyama Tetsuya Hosaka Satoshi Saitoh Hitomi Sezaki Norio Akuta Fumitaka Suzuki Yoshiyuki Suzuki Kenji Ikeda Yasuji Arase Masaji Has Source Type: research

A Case of Duloxetine-induced Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Super-elderly Patient
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7722-21. Online ahead of print.ABSTRACTDuloxetine is widely used for pain control and depressive syndromes. One of its potential side effects is syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Duloxetine-induced SIADH causes hyponatremia, which leads to a variety of symptoms and has previously been reported in the elderly. In the present case, we experienced a case of the rapid onset of SIADH in a super-elderly woman receiving low-dose duloxetine. Elderly patients tend to have lower duloxetine doses and an earlier onset than non-elderly patients. W...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Toru Hamada Katsuyuki Matsuki Seiji Kondou Shinya Furukawa Morikazu Onji Source Type: research

Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7802-21. Online ahead of print.ABSTRACTObjective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 vent...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Hiroyuki Ishiyama Junko Ishii Hajime Yoshimura Marie Tsunogae Satoru Fujiwara Satomi Hiya Ryoma Inui Yuma Shiomi Shinsaku Nakazawa Masamune Kimura Takehito Kuroda Yasutaka Murakami Kota Maekawa Nobuyuki Ohara Nobuo Kohara Michi Kawamoto Source Type: research

A Case of Repeated Necrotizing Lymphadenitis with MEFV Gene Mutations
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7882-21. Online ahead of print.ABSTRACTWe herein report a 36-year-old man with repeated necrotizing lymphadenitis due to MEFV gene mutations. The patient's chief complaints were a fever and painful cervical lymphadenopathy. We diagnosed him with necrotizing lymphadenitis based on the pathological findings of the lymph nodes and the exclusion of other differential diseases. The same episode recurred four times. We speculated the involvement of autoinflammatory backgrounds and detected MEFV gene mutations of E148Q (homo), P369S, and R408Q. Considering the elevation of in...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Yuta Yamamura Kengo Furuichi Tadashi Toyama Megumi Oshima Hisayuki Ogura Koichi Sato Shiori Nakagawa Taro Miyagawa Shinji Kitajima Akinori Hara Yasunori Iwata Norihiko Sakai Miho Shimizu Hiroko Ikeda Tomoko Toma Kazuya Takasawa Akihiro Yachie Takashi Wada Source Type: research

Endoscopic Ultrasonography-guided Fine-needle Aspiration Cytology Combined with a Cell-block Method for Gastrointestinal Subepithelial Lesions
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7889-21. Online ahead of print.ABSTRACTIntroduction The diagnostic accuracy of an endoscopic ultrasound-guided fine-needle aspiration cytology/biopsy combined with a cell-block method (FNA-CB) for gastrointestinal subepithelial lesions (GI-SELs) has not been fully studied. Methods A total of 109 patients (with 110 GI-SELs) were evaluated to clarify the rate of obtaining evaluable histology specimens using FNA-CB. In addition, we investigated the following: 1) the accuracy for determining the histology, 2) effects of the number of cell clusters obtained via FNA-CB, 3) c...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Takeshi Shimizu Shinsuke Koshita Tetsuya Ohira Yoshihiro Harada Yoshihide Kanno Takahisa Ogawa Taku Yamagata Hiroaki Kusunose Toshitaka Sakai Takashi Tsuchiya Masaya Oikawa Yutaka Noda Takashi Sawai Kei Ito Source Type: research

Successful Management of Subacute Thyroiditis Following SARS-CoV-2 Infection: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7913-21. Online ahead of print.ABSTRACTSubacute thyroiditis (SAT) is a disorder of the thyroid gland and difficult to diagnose. It is probably triggered by a viral infection. Recently, several articles have reported SAT after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports describing SAT after SARS-CoV-2 in Japan are lacking. We herein report the first case of SAT after SARS-CoV-2 infection in Japan. After SARS-CoV-2 infection, some patients can develop not only pneumonia but also SAT. Thus, a careful follow-up is recommended for patients...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Daisuke Sato Sho Nishiguchi Eri Tanaka Source Type: research

Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia
Conclusion Low PICC-related complication rates, possibly associated with high rates of catheter removal, were observed during intensive chemotherapy for AML. Women and obese patients require careful monitoring of their PICC. Procedures to achieve appropriate PICC removal without increasing the complication rate need to be considered.PMID:34511570 | DOI:10.2169/internalmedicine.8184-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Tetsuaki Ban Shin-Ichiro Fujiwara Rui Murahashi Hirotomo Nakajima Takashi Ikeda Sae Matsuoka Yumiko Toda Shin-Ichiro Kawaguchi Shoko Ito Takashi Nagayama Kento Umino Daisuke Minakata Hirofumi Nakano Kaoru Morita Masahiro Ashizawa Chihiro Yamamoto Kaoru Ha Source Type: research

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8205-21. Online ahead of print.ABSTRACTObjective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Method This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic dru...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Shin-Ichiro Ohmura Yoichiro Homma Takayuki Masui Toshiaki Miyamoto Source Type: research

Mediastinal Lymph Node Metastasis of Esophageal Cancer with Esophageal Stenosis Diagnosed via Transesophageal Endoscopic Ultrasound with Bronchoscope-Guided Fine-needle Aspiration: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8214-21. Online ahead of print.ABSTRACTAn 80-year-old man underwent follow-up examinations after endoscopic submucosal dissection (ESD) for esophageal cancer. Computed tomography (CT) showed enlarged lymph nodes of the right recurrent nerve. The patient had esophageal stenosis due to repeated ESD for multiple esophageal tumors. The stenosis made the passage of an endoscopic ultrasound (EUS) scope through the esophagus difficult. Thus, an endobronchial ultrasound bronchoscope, which had a thinner diameter than that of the EUS scope, was used for transesophageal endoscop...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Emi Tanaka Naohiro Oda Sayo Kobayashi Tsuneyoshi Ogawa Reo Mitani Toru Nawa Ichiro Takata Toru Ueki Hiroyuki Okada Source Type: research

Aleukemic Extramedullary Blast Crisis as an initial presentation of Chronic Myeloid Leukemia with E1A3 BCR-ABL1 Fusion Transcript
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8319-21. Online ahead of print.ABSTRACTRight neck swelling and pain occurred in a 49-year-old man. A Blood count showed a slight increase in platelet count without leukemoid reaction. After a biopsy of the cervical mass and bone marrow aspiration, a diagnosis of extramedullary blast crisis (EBC) of chronic myeloid leukemia (CML) was made. FISH analysis showed a BCR-ABL1 fusion signal, but results of RT-PCR for major and minor BCR-ABL1 transcripts were negative. We identified a rare e1a3 BCR-ABL1 fusion transcript. Administration of dasatinib resulted in disappearance o...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Naoki Miyashita Masahiro Onozawa Keito Suto Shinichi Fujisawa Nanase Okazaki Daisuke Hidaka Hiroyuki Ohigashi Atsushi Yasumoto Junichi Sugita Daigo Hashimoto Yoshihiro Matsuno Takanori Teshima Source Type: research

Remote Death Certification Using Telemedicine in Japan
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.6588-20. Online ahead of print.ABSTRACTA 92-year-old woman diagnosed with dementia and end-stage gastric cancer received end-of-life care on the island where she lived. Informed consent concerning remote death certification based on the Japanese government's guidelines was obtained from a family member in case a physician was unavailable. A physical examination after cardiopulmonary arrest was conducted, supported by telemedicine and a well-trained registered nurse under remote supervision of the physician who last saw the deceased directly. Death certification was pro...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Kemmyo Sugiyama Shintaro Yanaka Toshiaki Yasuda Takashi Watanabe Akira Yamashiro Junichi Narita Akio Tomoda Isamu Sohtome Source Type: research

Changes in the Mean Intrahepatic Target Computed Tomography Attenuation Value During Treatment May be a Useful New Predictor of the Post-progression Survival Associated with Lenvatinib Treatment
Conclusion A rate of decrease in attenuation ≥40% may reflect a good response of a highly malignant tumor to lenvatinib. Therefore, this value may have utility as a surrogate marker for estimating the oncological aggressiveness of tumors and their associated prognosis.PMID:34511564 | DOI:10.2169/internalmedicine.7589-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Nozomu Muraishi Yusuke Kawamura Masahiro Kobayashi Junichi Shindoh Yuta Kobayashi Satoshi Okubo Soichi Iritani Shunichiro Fujiyama Tetsuya Hosaka Satoshi Saitoh Hitomi Sezaki Norio Akuta Fumitaka Suzuki Yoshiyuki Suzuki Kenji Ikeda Yasuji Arase Masaji Has Source Type: research

A Case of Duloxetine-induced Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Super-elderly Patient
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7722-21. Online ahead of print.ABSTRACTDuloxetine is widely used for pain control and depressive syndromes. One of its potential side effects is syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Duloxetine-induced SIADH causes hyponatremia, which leads to a variety of symptoms and has previously been reported in the elderly. In the present case, we experienced a case of the rapid onset of SIADH in a super-elderly woman receiving low-dose duloxetine. Elderly patients tend to have lower duloxetine doses and an earlier onset than non-elderly patients. W...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Toru Hamada Katsuyuki Matsuki Seiji Kondou Shinya Furukawa Morikazu Onji Source Type: research

Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7802-21. Online ahead of print.ABSTRACTObjective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 vent...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Hiroyuki Ishiyama Junko Ishii Hajime Yoshimura Marie Tsunogae Satoru Fujiwara Satomi Hiya Ryoma Inui Yuma Shiomi Shinsaku Nakazawa Masamune Kimura Takehito Kuroda Yasutaka Murakami Kota Maekawa Nobuyuki Ohara Nobuo Kohara Michi Kawamoto Source Type: research

A Case of Repeated Necrotizing Lymphadenitis with MEFV Gene Mutations
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7882-21. Online ahead of print.ABSTRACTWe herein report a 36-year-old man with repeated necrotizing lymphadenitis due to MEFV gene mutations. The patient's chief complaints were a fever and painful cervical lymphadenopathy. We diagnosed him with necrotizing lymphadenitis based on the pathological findings of the lymph nodes and the exclusion of other differential diseases. The same episode recurred four times. We speculated the involvement of autoinflammatory backgrounds and detected MEFV gene mutations of E148Q (homo), P369S, and R408Q. Considering the elevation of in...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Yuta Yamamura Kengo Furuichi Tadashi Toyama Megumi Oshima Hisayuki Ogura Koichi Sato Shiori Nakagawa Taro Miyagawa Shinji Kitajima Akinori Hara Yasunori Iwata Norihiko Sakai Miho Shimizu Hiroko Ikeda Tomoko Toma Kazuya Takasawa Akihiro Yachie Takashi Wada Source Type: research

Endoscopic Ultrasonography-guided Fine-needle Aspiration Cytology Combined with a Cell-block Method for Gastrointestinal Subepithelial Lesions
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7889-21. Online ahead of print.ABSTRACTIntroduction The diagnostic accuracy of an endoscopic ultrasound-guided fine-needle aspiration cytology/biopsy combined with a cell-block method (FNA-CB) for gastrointestinal subepithelial lesions (GI-SELs) has not been fully studied. Methods A total of 109 patients (with 110 GI-SELs) were evaluated to clarify the rate of obtaining evaluable histology specimens using FNA-CB. In addition, we investigated the following: 1) the accuracy for determining the histology, 2) effects of the number of cell clusters obtained via FNA-CB, 3) c...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Takeshi Shimizu Shinsuke Koshita Tetsuya Ohira Yoshihiro Harada Yoshihide Kanno Takahisa Ogawa Taku Yamagata Hiroaki Kusunose Toshitaka Sakai Takashi Tsuchiya Masaya Oikawa Yutaka Noda Takashi Sawai Kei Ito Source Type: research

Successful Management of Subacute Thyroiditis Following SARS-CoV-2 Infection: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7913-21. Online ahead of print.ABSTRACTSubacute thyroiditis (SAT) is a disorder of the thyroid gland and difficult to diagnose. It is probably triggered by a viral infection. Recently, several articles have reported SAT after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports describing SAT after SARS-CoV-2 in Japan are lacking. We herein report the first case of SAT after SARS-CoV-2 infection in Japan. After SARS-CoV-2 infection, some patients can develop not only pneumonia but also SAT. Thus, a careful follow-up is recommended for patients...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Daisuke Sato Sho Nishiguchi Eri Tanaka Source Type: research

Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia
Conclusion Low PICC-related complication rates, possibly associated with high rates of catheter removal, were observed during intensive chemotherapy for AML. Women and obese patients require careful monitoring of their PICC. Procedures to achieve appropriate PICC removal without increasing the complication rate need to be considered.PMID:34511570 | DOI:10.2169/internalmedicine.8184-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Tetsuaki Ban Shin-Ichiro Fujiwara Rui Murahashi Hirotomo Nakajima Takashi Ikeda Sae Matsuoka Yumiko Toda Shin-Ichiro Kawaguchi Shoko Ito Takashi Nagayama Kento Umino Daisuke Minakata Hirofumi Nakano Kaoru Morita Masahiro Ashizawa Chihiro Yamamoto Kaoru Ha Source Type: research

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8205-21. Online ahead of print.ABSTRACTObjective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Method This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic dru...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Shin-Ichiro Ohmura Yoichiro Homma Takayuki Masui Toshiaki Miyamoto Source Type: research

Mediastinal Lymph Node Metastasis of Esophageal Cancer with Esophageal Stenosis Diagnosed via Transesophageal Endoscopic Ultrasound with Bronchoscope-Guided Fine-needle Aspiration: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8214-21. Online ahead of print.ABSTRACTAn 80-year-old man underwent follow-up examinations after endoscopic submucosal dissection (ESD) for esophageal cancer. Computed tomography (CT) showed enlarged lymph nodes of the right recurrent nerve. The patient had esophageal stenosis due to repeated ESD for multiple esophageal tumors. The stenosis made the passage of an endoscopic ultrasound (EUS) scope through the esophagus difficult. Thus, an endobronchial ultrasound bronchoscope, which had a thinner diameter than that of the EUS scope, was used for transesophageal endoscop...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Emi Tanaka Naohiro Oda Sayo Kobayashi Tsuneyoshi Ogawa Reo Mitani Toru Nawa Ichiro Takata Toru Ueki Hiroyuki Okada Source Type: research

Aleukemic Extramedullary Blast Crisis as an initial presentation of Chronic Myeloid Leukemia with E1A3 BCR-ABL1 Fusion Transcript
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8319-21. Online ahead of print.ABSTRACTRight neck swelling and pain occurred in a 49-year-old man. A Blood count showed a slight increase in platelet count without leukemoid reaction. After a biopsy of the cervical mass and bone marrow aspiration, a diagnosis of extramedullary blast crisis (EBC) of chronic myeloid leukemia (CML) was made. FISH analysis showed a BCR-ABL1 fusion signal, but results of RT-PCR for major and minor BCR-ABL1 transcripts were negative. We identified a rare e1a3 BCR-ABL1 fusion transcript. Administration of dasatinib resulted in disappearance o...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Naoki Miyashita Masahiro Onozawa Keito Suto Shinichi Fujisawa Nanase Okazaki Daisuke Hidaka Hiroyuki Ohigashi Atsushi Yasumoto Junichi Sugita Daigo Hashimoto Yoshihiro Matsuno Takanori Teshima Source Type: research

Remote Death Certification Using Telemedicine in Japan
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.6588-20. Online ahead of print.ABSTRACTA 92-year-old woman diagnosed with dementia and end-stage gastric cancer received end-of-life care on the island where she lived. Informed consent concerning remote death certification based on the Japanese government's guidelines was obtained from a family member in case a physician was unavailable. A physical examination after cardiopulmonary arrest was conducted, supported by telemedicine and a well-trained registered nurse under remote supervision of the physician who last saw the deceased directly. Death certification was pro...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Kemmyo Sugiyama Shintaro Yanaka Toshiaki Yasuda Takashi Watanabe Akira Yamashiro Junichi Narita Akio Tomoda Isamu Sohtome Source Type: research

Changes in the Mean Intrahepatic Target Computed Tomography Attenuation Value During Treatment May be a Useful New Predictor of the Post-progression Survival Associated with Lenvatinib Treatment
Conclusion A rate of decrease in attenuation ≥40% may reflect a good response of a highly malignant tumor to lenvatinib. Therefore, this value may have utility as a surrogate marker for estimating the oncological aggressiveness of tumors and their associated prognosis.PMID:34511564 | DOI:10.2169/internalmedicine.7589-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Nozomu Muraishi Yusuke Kawamura Masahiro Kobayashi Junichi Shindoh Yuta Kobayashi Satoshi Okubo Soichi Iritani Shunichiro Fujiyama Tetsuya Hosaka Satoshi Saitoh Hitomi Sezaki Norio Akuta Fumitaka Suzuki Yoshiyuki Suzuki Kenji Ikeda Yasuji Arase Masaji Has Source Type: research

A Case of Duloxetine-induced Syndrome of Inappropriate Secretion of Antidiuretic Hormone in a Super-elderly Patient
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7722-21. Online ahead of print.ABSTRACTDuloxetine is widely used for pain control and depressive syndromes. One of its potential side effects is syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Duloxetine-induced SIADH causes hyponatremia, which leads to a variety of symptoms and has previously been reported in the elderly. In the present case, we experienced a case of the rapid onset of SIADH in a super-elderly woman receiving low-dose duloxetine. Elderly patients tend to have lower duloxetine doses and an earlier onset than non-elderly patients. W...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Toru Hamada Katsuyuki Matsuki Seiji Kondou Shinya Furukawa Morikazu Onji Source Type: research

Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7802-21. Online ahead of print.ABSTRACTObjective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 vent...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Hiroyuki Ishiyama Junko Ishii Hajime Yoshimura Marie Tsunogae Satoru Fujiwara Satomi Hiya Ryoma Inui Yuma Shiomi Shinsaku Nakazawa Masamune Kimura Takehito Kuroda Yasutaka Murakami Kota Maekawa Nobuyuki Ohara Nobuo Kohara Michi Kawamoto Source Type: research

A Case of Repeated Necrotizing Lymphadenitis with MEFV Gene Mutations
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7882-21. Online ahead of print.ABSTRACTWe herein report a 36-year-old man with repeated necrotizing lymphadenitis due to MEFV gene mutations. The patient's chief complaints were a fever and painful cervical lymphadenopathy. We diagnosed him with necrotizing lymphadenitis based on the pathological findings of the lymph nodes and the exclusion of other differential diseases. The same episode recurred four times. We speculated the involvement of autoinflammatory backgrounds and detected MEFV gene mutations of E148Q (homo), P369S, and R408Q. Considering the elevation of in...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Yuta Yamamura Kengo Furuichi Tadashi Toyama Megumi Oshima Hisayuki Ogura Koichi Sato Shiori Nakagawa Taro Miyagawa Shinji Kitajima Akinori Hara Yasunori Iwata Norihiko Sakai Miho Shimizu Hiroko Ikeda Tomoko Toma Kazuya Takasawa Akihiro Yachie Takashi Wada Source Type: research

Endoscopic Ultrasonography-guided Fine-needle Aspiration Cytology Combined with a Cell-block Method for Gastrointestinal Subepithelial Lesions
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7889-21. Online ahead of print.ABSTRACTIntroduction The diagnostic accuracy of an endoscopic ultrasound-guided fine-needle aspiration cytology/biopsy combined with a cell-block method (FNA-CB) for gastrointestinal subepithelial lesions (GI-SELs) has not been fully studied. Methods A total of 109 patients (with 110 GI-SELs) were evaluated to clarify the rate of obtaining evaluable histology specimens using FNA-CB. In addition, we investigated the following: 1) the accuracy for determining the histology, 2) effects of the number of cell clusters obtained via FNA-CB, 3) c...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Takeshi Shimizu Shinsuke Koshita Tetsuya Ohira Yoshihiro Harada Yoshihide Kanno Takahisa Ogawa Taku Yamagata Hiroaki Kusunose Toshitaka Sakai Takashi Tsuchiya Masaya Oikawa Yutaka Noda Takashi Sawai Kei Ito Source Type: research

Successful Management of Subacute Thyroiditis Following SARS-CoV-2 Infection: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.7913-21. Online ahead of print.ABSTRACTSubacute thyroiditis (SAT) is a disorder of the thyroid gland and difficult to diagnose. It is probably triggered by a viral infection. Recently, several articles have reported SAT after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports describing SAT after SARS-CoV-2 in Japan are lacking. We herein report the first case of SAT after SARS-CoV-2 infection in Japan. After SARS-CoV-2 infection, some patients can develop not only pneumonia but also SAT. Thus, a careful follow-up is recommended for patients...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Daisuke Sato Sho Nishiguchi Eri Tanaka Source Type: research

Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia
Conclusion Low PICC-related complication rates, possibly associated with high rates of catheter removal, were observed during intensive chemotherapy for AML. Women and obese patients require careful monitoring of their PICC. Procedures to achieve appropriate PICC removal without increasing the complication rate need to be considered.PMID:34511570 | DOI:10.2169/internalmedicine.8184-21 (Source: Internal Medicine)
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Tetsuaki Ban Shin-Ichiro Fujiwara Rui Murahashi Hirotomo Nakajima Takashi Ikeda Sae Matsuoka Yumiko Toda Shin-Ichiro Kawaguchi Shoko Ito Takashi Nagayama Kento Umino Daisuke Minakata Hirofumi Nakano Kaoru Morita Masahiro Ashizawa Chihiro Yamamoto Kaoru Ha Source Type: research

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8205-21. Online ahead of print.ABSTRACTObjective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Method This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic dru...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Shin-Ichiro Ohmura Yoichiro Homma Takayuki Masui Toshiaki Miyamoto Source Type: research

Mediastinal Lymph Node Metastasis of Esophageal Cancer with Esophageal Stenosis Diagnosed via Transesophageal Endoscopic Ultrasound with Bronchoscope-Guided Fine-needle Aspiration: A Case Report
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8214-21. Online ahead of print.ABSTRACTAn 80-year-old man underwent follow-up examinations after endoscopic submucosal dissection (ESD) for esophageal cancer. Computed tomography (CT) showed enlarged lymph nodes of the right recurrent nerve. The patient had esophageal stenosis due to repeated ESD for multiple esophageal tumors. The stenosis made the passage of an endoscopic ultrasound (EUS) scope through the esophagus difficult. Thus, an endobronchial ultrasound bronchoscope, which had a thinner diameter than that of the EUS scope, was used for transesophageal endoscop...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Emi Tanaka Naohiro Oda Sayo Kobayashi Tsuneyoshi Ogawa Reo Mitani Toru Nawa Ichiro Takata Toru Ueki Hiroyuki Okada Source Type: research

Aleukemic Extramedullary Blast Crisis as an initial presentation of Chronic Myeloid Leukemia with E1A3 BCR-ABL1 Fusion Transcript
Intern Med. 2021 Sep 11. doi: 10.2169/internalmedicine.8319-21. Online ahead of print.ABSTRACTRight neck swelling and pain occurred in a 49-year-old man. A Blood count showed a slight increase in platelet count without leukemoid reaction. After a biopsy of the cervical mass and bone marrow aspiration, a diagnosis of extramedullary blast crisis (EBC) of chronic myeloid leukemia (CML) was made. FISH analysis showed a BCR-ABL1 fusion signal, but results of RT-PCR for major and minor BCR-ABL1 transcripts were negative. We identified a rare e1a3 BCR-ABL1 fusion transcript. Administration of dasatinib resulted in disappearance o...
Source: Internal Medicine - September 13, 2021 Category: Internal Medicine Authors: Naoki Miyashita Masahiro Onozawa Keito Suto Shinichi Fujisawa Nanase Okazaki Daisuke Hidaka Hiroyuki Ohigashi Atsushi Yasumoto Junichi Sugita Daigo Hashimoto Yoshihiro Matsuno Takanori Teshima Source Type: research

Immunoglobulin G4-related Pleuritis Complicated with Minimal Change Disease: A Case Report
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7010-20. Online ahead of print.ABSTRACTA 70-year-old woman with bilateral pleural effusion and respiratory failure was admitted to our hospital. Nephrotic syndrome due to minimal change disease had been diagnosed four months before admission. Because blood tests and a pleural fluid analysis did not reveal the etiology of her condition, we performed a video-assisted thoracoscopic pleural biopsy. No specific thoracoscopic findings were noted. The pathological findings revealed an increase in immunoglobulin G4 (IgG4)-positive cells; IgG4-related pleuritis was diagnosed. He...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Yoshiko Mizushina Jun Shiihara Motoko Nomura Hiromitsu Ohta Fumiyoshi Ohyanagi Yoshiyuki Morishita Hiroyoshi Tsubochi Akira Tanaka Yasuhiro Yamaguchi Source Type: research

Recurrent Cerebral Infarcts Associated with Uterine Adenomyosis: Successful Prevention by Surgical Removal
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7320-21. Online ahead of print.ABSTRACTHypercoagulability associated with malignant tumors causes thrombosis, termed Trousseau's syndrome, but is rarely associated with benign gynecological tumors, such as myoma and adenomyosis. We herein report a 47-year-old Japanese woman with uterine adenomyosis who developed multiple cerebral infarcts during menstruation. Edoxaban was initially used for prevention but failed to prevent recurrence of thrombosis. However, hysterectomy and bilateral salpingo-oophorectomy resulted in the successful prevention of recurrence of cerebral i...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Manato Yasuda Yoshitaka Yamanaka Hiroki Kano Nobuyuki Araki Hiroshi Ishikawa Jun-Ichiro Ikeda Satoshi Kuwabara Source Type: research

Disseminated Carcinomatosis of Bone Marrow as the Initial Presentation of Intrahepatic Cholangiocarcinoma Without Jaundice: An Autopsy Case Report
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7688-21. Online ahead of print.ABSTRACTDisseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lys...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Taiki Okumura Kenta Mitsui Seiichi Daikuhara Toshiharu Tatai Hiroko Itagaki Hideharu Miyabayashi Yukio Gibo Source Type: research

Real-world Safety and Efficacy of Indacaterol/Glycopyrronium in Japanese Patients with Chronic Obstructive Pulmonary Disease: A 52-week Post-marketing Surveillance
Conclusion IND/GLY demonstrated a good long-term safety profile in a real-world setting in Japanese patients with COPD, with beneficial effects in terms of the lung function and symptoms in clinical use.PMID:34483208 | DOI:10.2169/internalmedicine.7845-21 (Source: Internal Medicine)
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Chihiro Kato Hajime Yoshisue Noriko Nakamura Takayoshi Sasajima Source Type: research

Persistent Hypoglycemia Induced by Long-acting Insulin Degludec
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7915-21. Online ahead of print.ABSTRACTA 58-year-old Japanese man was brought to the emergency room due to disturbance of consciousness. He regained consciousness on the day of admission and started taking hospital meals, but he needed intravenous glucose administration for eight days. The total amount of glucose administration was 4,464 g. It took over three weeks for exogenous insulin to be almost undetectable. While degludec binds to albumin and exerts glucose-lowering effects for a long time, the above-mentioned period of three weeks was consistent with the half-lif...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Yukino Katakura Fuminori Tatsumi Takashi Kusano Masashi Shimoda Kenji Kohara Tomohiko Kimura Atsushi Obata Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto Source Type: research

Aseptic Cavernosal Abscess: An Unrecognized Feature of Neutrophilic Dermatosis
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7994-21. Online ahead of print.ABSTRACTA 50-year-old man developed a sterile cavernosal abscess followed by prominent features of necrotizing neutrophilic dermatosis. We conducted a literature review, which revealed that aseptic abscesses in the corpus cavernosum occur in association with neutrophilic dermatosis. Patients with this condition frequently receive unnecessary antibiotic treatment and surgical interventions. Although this condition responds to systemic corticosteroids, the functional prognosis of the penis is poor. Abscess formation may be the initial presen...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Yu Akagi Yuri Yamagiwa Harumi Shirai Takeshi Suzuki Ibuki Tsuru Akira Ishikawa Naoki Akiyama Mizuki Ogura Kanae Kobayashi Yuan Bae Yamato Suemitsu Sumihisa Imakado Momoko Mawatari Akihiro Ueda Source Type: research

Multiple Cerebral Infarctions Accompanied by Subcortical and Subarachnoid Hemorrhaging in Bilateral Border Zone Areas in a Patient with Eosinophilic Granulomatosis with Polyangiitis
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7999-21. Online ahead of print.ABSTRACTEosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis media, sinusitis, and hemorrhagic colitis. She subsequently developed hemiparesis. Head magnetic resonance imaging revealed multiple cerebral infarctions with subcortical and subarachnoid hemorrhaging colocalized at the bilateral border zon...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Toshikazu Mino Hiroka Sakaguchi Itsuki Hasegawa Akitoshi Takeda Takahito Yoshizaki Takato Abe Yoshiaki Itoh Source Type: research

Drastic Improvement of Myocardial Infiltration of Malignant Lymphoma
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8023-21. Online ahead of print.NO ABSTRACTPMID:34483212 | DOI:10.2169/internalmedicine.8023-21 (Source: Internal Medicine)
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Teruhiko Imamura Koichiro Kinugawa Source Type: research

Characteristics of Ischemic Versus Hemorrhagic Stroke in Patients Receiving Oral Anticoagulants: Results of the PASTA Study
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8113-21. Online ahead of print.ABSTRACTObjective Limited data exist regarding the comparative detailed clinical characteristics of patients with ischemic stroke (IS)/transient ischemic attack (TIA) and intracerebral hemorrhage (ICH) receiving oral anticoagulants (OACs). Methods The prospective analysis of stroke patients taking oral anticoagulants (PASTA) registry, a multicenter registry of 1,043 stroke patients receiving OACs (vitamin K antagonists [VKAs] or non-vitamin K oral antagonists [NOACs]) across 25 medical institutions throughout Japan, was used. Univariate an...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Satoshi Suda Arata Abe Yasuyuki Iguchi Yoshiki Yagita Takao Kanzawa Seiji Okubo Nobuyuki Ohara Takayuki Mizunari Mineo Yamazaki Nobuhito Nakajima Kimito Kondo Shigeru Fujimoto Takeshi Inoue Takeshi Iwanaga Yuka Terasawa Kensaku Shibazaki Yu Kono Makoto Na Source Type: research

An Evaluation of Endoscopic Images from Over 15 Years Prior to the Diagnosis of Autoimmune Gastritis: A Report of Three Patients
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8178-21. Online ahead of print.ABSTRACTWe herein describe three patients whose endoscopic images from over 15 years prior to their diagnosis of autoimmune gastritis (AIG) were available for review. All patients had corpus-dominant atrophic gastritis at the time of the diagnosis of AIG. Previous endoscopic images without severe atrophy showed erythema restricted to the fundic mucosa. These findings are suggestive of ongoing gastritis in patients with AIG. Initial endoscopy in Patient 2 showed multiple hyperplastic polyps that decreased in size and number over the course ...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Maki Ayaki Noriaki Manabe Masayuki Murota Minoru Fujita Ken Haruma Source Type: research

Wheezing and Weightlifting
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8179-21. Online ahead of print.NO ABSTRACTPMID:34483215 | DOI:10.2169/internalmedicine.8179-21 (Source: Internal Medicine)
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Satoru Yanagisawa Satoshi Wasamoto Hiroki Takechi Yuki Hata Source Type: research

Intramural Esophageal Hematoma with Herpes Esophagitis
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8284-21. Online ahead of print.NO ABSTRACTPMID:34483216 | DOI:10.2169/internalmedicine.8284-21 (Source: Internal Medicine)
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Kiyoshi Takemoto Kazuaki Atagi Source Type: research

A Case of Massive Polycystic Liver with a Poor Performance Status Successfully Treated by ABO-incompatible Adult Living-donor Liver Transplantation while Overcoming Complications
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.8290-21. Online ahead of print.ABSTRACTWe encountered a 47-year-old woman with polycystic liver disease (PLD) and severe malnutrition successfully treated by living-donor liver transplantation (LDLT). Her PLD became symptomatic with abdominal distension and appetite loss. Transcatheter arterial embolization and percutaneous cyst drainage failed to improve her symptoms. ABO-incompatible LDLT from her husband was performed after rituximab administration and mycophenolate mofetil introduction. Although she showed severe postoperative complications, she ultimately regained ...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Satoshi Takakusagi Yuichi Masuda Hitoshi Takagi Yozo Yokoyama Kazuko Kizawa Kyoko Marubashi Takashi Kosone Yuji Soejima Source Type: research

Immunoglobulin G4-related Pleuritis Complicated with Minimal Change Disease: A Case Report
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7010-20. Online ahead of print.ABSTRACTA 70-year-old woman with bilateral pleural effusion and respiratory failure was admitted to our hospital. Nephrotic syndrome due to minimal change disease had been diagnosed four months before admission. Because blood tests and a pleural fluid analysis did not reveal the etiology of her condition, we performed a video-assisted thoracoscopic pleural biopsy. No specific thoracoscopic findings were noted. The pathological findings revealed an increase in immunoglobulin G4 (IgG4)-positive cells; IgG4-related pleuritis was diagnosed. He...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Yoshiko Mizushina Jun Shiihara Motoko Nomura Hiromitsu Ohta Fumiyoshi Ohyanagi Yoshiyuki Morishita Hiroyoshi Tsubochi Akira Tanaka Yasuhiro Yamaguchi Source Type: research

Recurrent Cerebral Infarcts Associated with Uterine Adenomyosis: Successful Prevention by Surgical Removal
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7320-21. Online ahead of print.ABSTRACTHypercoagulability associated with malignant tumors causes thrombosis, termed Trousseau's syndrome, but is rarely associated with benign gynecological tumors, such as myoma and adenomyosis. We herein report a 47-year-old Japanese woman with uterine adenomyosis who developed multiple cerebral infarcts during menstruation. Edoxaban was initially used for prevention but failed to prevent recurrence of thrombosis. However, hysterectomy and bilateral salpingo-oophorectomy resulted in the successful prevention of recurrence of cerebral i...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Manato Yasuda Yoshitaka Yamanaka Hiroki Kano Nobuyuki Araki Hiroshi Ishikawa Jun-Ichiro Ikeda Satoshi Kuwabara Source Type: research

Disseminated Carcinomatosis of Bone Marrow as the Initial Presentation of Intrahepatic Cholangiocarcinoma Without Jaundice: An Autopsy Case Report
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7688-21. Online ahead of print.ABSTRACTDisseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lys...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Taiki Okumura Kenta Mitsui Seiichi Daikuhara Toshiharu Tatai Hiroko Itagaki Hideharu Miyabayashi Yukio Gibo Source Type: research

Real-world Safety and Efficacy of Indacaterol/Glycopyrronium in Japanese Patients with Chronic Obstructive Pulmonary Disease: A 52-week Post-marketing Surveillance
Conclusion IND/GLY demonstrated a good long-term safety profile in a real-world setting in Japanese patients with COPD, with beneficial effects in terms of the lung function and symptoms in clinical use.PMID:34483208 | DOI:10.2169/internalmedicine.7845-21 (Source: Internal Medicine)
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Chihiro Kato Hajime Yoshisue Noriko Nakamura Takayoshi Sasajima Source Type: research