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Antihistamines are known risk factors for restless legs syndrome (RLS). However, reports on RLS associated with fexofenadine or its combinations are rare. Here, we report a 30-year-old woman with RLS that was induced by fexofenadine/pseudoephedrine. She had been taking fexofenadine/pseudoephedrine for three months and felt a strong urge to move her legs at night, which was relieved by movement. Her condition improved by taking pramipexole, which she discontinued subsequently because of dizziness. One month later, she quitted taking fexofenadine/pseudoephedrine, after which her symptoms disappeared a week later. This case study demonstrates that RLS can be induced by fexofenadine/pseudoephedrine and we should always consider the possibility of drug-induced RLS.
Studies that have examined serum zinc deficiency/marginal deficiency in developed countries, including Japan, are still limited. The aim of this study was to assess serum zinc concentrations and associated characteristics among Japanese subjects.
This cross-sectional study, conducted from September 2016 to December 2018, included 2056 eligible subjects who participated in a voluntary health checkup. Serum zinc concentration categories were defined as deficiency (<60μg/dL), marginal deficiency (≥60 to <80μg/dL), and normal (≥80μg/dL). Serum zinc concentrations were compared between the first age category (<40years) and other age categories with Dunnett's method. Trends in P-values were estimated using the Jonckheere-Terpstra test for continuous variables.
The proportions of subjects with deficiency and marginal deficiency were 0.4% and 46.0% in men, and 0.6% and 38.4% in women, respectively. The deficiency/marginal deficiency group had significantly lower lipid profiles and nutritional status, and a significantly lower proportion were non-daily drinkers in both genders. Older age was significantly associated with lower serum zinc concentration only in men.
Our findings clarified a high proportion of serum zinc deficiency/marginal deficiency, especially in men, and suggest a possible association between serum zinc levels and nutritional status and alcohol consumption. It may be necessary to manage nutritional status, including zinc intake.
Our findings clarified a high proportion of serum zinc deficiency/marginal deficiency, especially in men, and suggest a possible association between serum zinc levels and nutritional status and alcohol consumption. It may be necessary to manage nutritional status, including zinc intake.
In 2004, Japan introduced a mandatory 2-year postgraduate training program for graduating medical students with a super-rotation curriculum. A national matching system was established to determine the hospital residency programs best suited for the students. We examined the hospital characteristics preferred by applicants for residencies.
A nationwide cross-sectional study was conducted. Data on salaries, bonuses, and number of accepted ambulances were compiled from the Residency Electronic Information System. Information on the prefectural population, urban area, and number of senior residents (postgraduate years 3-5) for specialty training was extracted from data published on the web page. The ratio of the number of first-choice applicants to recruitment capacity (matching ratio) for each program was compared between the characteristics of the hospitals and prefectures.
A strong linear relationship was observed between the number of first-choice applications and the allocated number of resident positiety of cases.
Emergency admissions of ambulatory care sensitive conditions (ACSCs) are a key marker of quality of primary care and are used nationwide in some countries including the UK and Australia. There are still little data on ACSCs available in Japan. This study aimed to provide the descriptive data of the current state of ACSCs at a local hospital in Japan.
This is an observational study of retrospective chart review. The study setting is Funabashi Futawa Hospital (FFH), an acute care private hospital in Funabashi City, Japan. We analyzed the shares of admissions of ACSCs out of all admissions at FFH from April 2014 to March 2015.
5380 charts were reviewed. Emergency admissions were 3275 cases (61%) of all admissions. Emergency admissions for ACSCs accounted for 946 cases (28.9%) of all emergency admissions. Chronic ACSC is the most common subcategory. Urinary tract infection accounted most for admissions of acute ACSCs (138 cases, 4.2% of all emergency admissions). Asthma accounted most for admissions of chronic ACSCs (139 cases, 4.2%). Pneumonia accounted most for admissions of vaccine-preventable ACSCs (99 cases, 3.0%).
This is one of the first reports describing ACSCs in Japan. Most common reasons for ACSCs were similar to the previous data from the UK, except COPD ranked lower and asthma ranked higher, respectively. Comparison among different facilities (horizontal) and over time in the same institution (longitudinal), as well as analyzing relationships between other markers of primary care quality and ACSCs, will be necessary in the future.
This is one of the first reports describing ACSCs in Japan. Most common reasons for ACSCs were similar to the previous data from the UK, except COPD ranked lower and asthma ranked higher, respectively. Comparison among different facilities (horizontal) and over time in the same institution (longitudinal), as well as analyzing relationships between other markers of primary care quality and ACSCs, will be necessary in the future.
Patients with acute respiratory tract infections are frequently prescribed antimicrobials despite high rates of virus detection. Physicians may overprescribe antimicrobials owing to the concern of bacterial infections, including those because of atypical pathogens. We investigated the accuracy of clinical predictions concerning atypical pathogen infections.
We prospectively enrolled adult patients who presented with a fever and cough in outpatient clinics between December 2016 and August 2018. After taking a history and performing physical examinations, physicians predicted the possibility of respiratory infections because of atypical pathogens. EGFR-IN-7 Disease probabilities were categorized into 3 grades (high ≥50%, intermediate 20% ≥ and <50%, and low <20%) and were judged by physicians who were taking care of the patients. Confirmation of atypical pathogens was performed by comprehensive molecular analyses of respiratory samples.
Atypical pathogens were detected in 21 of 210 patients. A close contact history (odds ratio [OR] 11.4, 95% confidence interval [CI] 2.4-53.5) and the presence of pneumonia (OR 12.9, CI 4.3-39.2) were associated with the detections. Atypical pathogens were detected in 32.3% of high-probability cases (10/31), while atypical pathogens were only detected in 8.8% of intermediate-probability cases (8/91) and 3.4% of low-probability cases (3/88) (
<.001).
The current study indicates that physicians' predictions were associated with the detection of atypical pathogens; however, overestimation was observed.
The current study indicates that physicians' predictions were associated with the detection of atypical pathogens; however, overestimation was observed.
The shortage of physicians in several specialties has been brought to public attention in several countries. However, little is known about factors affecting medical students' specialty choice. The objectives of our study were to illustrate medical students' career priority clusters and to assess their association with specialty preference.
We conducted a nationwide multicenter survey in 2015 at 17 medical schools. The study participants were asked their top three specialty preferences, demographic characteristics, and 14 career priority questions. Multilevel logistic regression models were used to determine the effect of each variable on student career choice.
A total of 1264 responses were included in the analyses. The top five specialty choices were internal medicine 833, general practice 408, pediatrics 372, surgery 344, and emergency medicine 244. An exploratory factor analysis mapped the 14 career priorities into 3-factor solution "primary care orientation," "advanced and specific care," and "persh specialty fields.JMDC, Inc. (JMDC) has created a database, using data collected from medical institutions in Japan, consisting of claims (for hospitalization and outpatient treatment), diagnosis procedure combination (DPC) assessment forms, and clinical laboratory test values. The oldest data in this database that can be accessed relate to treatment in April 2014. Currently (the end of October 2019), the number of medical institutions is 218, consisting of 131 DPC-eligible hospitals and 87 DPC-ineligible hospitals. Using this database, it is possible to carry out an analysis that makes up for certain limitations of JMDC's another database of data from health insurance societies (eg, the disease status and test results cannot be ascertained, and there is insufficient access to data for elderly people). In addition, it is noteworthy that this database includes not only data from DPC-eligible hospitals but also data from some DPC-ineligible hospitals.Intrinsically disordered proteins are those proteins with intrinsically disordered regions. One of the unique characteristics of intrinsically disordered proteins is the existence of functional segments in intrinsically dis-ordered regions. These segments are involved in binding to partner molecules, such as protein and DNA, and play important roles in signaling pathways and/or transcriptional regulation. Although there are databases that gather information on such disordered binding regions, data remain limited. Therefore, it is desirable to develop programs to predict the disordered binding regions without using data for the binding regions. We developed a program, NeProc, to predict the disordered binding regions, which can be regarded as intrinsically disordered regions with a structural propensity. We only used data for the structural domains and intrinsically disordered regions to detect such regions. NeProc accepts a query amino acid sequence converted into a position specific score matrix, and uses two neural networks that employ different window sizes, a neural network of short windows, and a neural network of long windows. The performance of NeProc was comparable to that of existing programs of the disordered binding region prediction. This result presents the possibility to overcome the shortage of the disordered binding region data in the development of the prediction programs for these binding regions. NeProc is available at http//flab.neproc.org/neproc/index.html.
This study evaluated, from a histological point of view, the process of repairing skin wounds caused in the dorsal region of rats when subjected to treatment with vitamin C, low-intensity laser, and association of both.
Forty-eight adult male rats (
, albinus, Wistar), weighing between 250 and 300 g were used in this study. The rats were anesthetized with sodium pentobarbital (10 mg/kg) intraperitoneally (IP) and a circular area of skin of approximately 8 mm in diameter was removed from the dorsal region of their back by a punch. The animals were randomly divided into four groups of 12 individuals Group I, control group, was treated with saline solution; Group II was treated with topical application of vitamin C; Group III was treated with low-intensity laser; and Group IV was treated with both low-intensity laser and topical application of vitamin C. Samples were histologically analyzed through optical microscopy with hematoxylin and eosin staining and collagen I and III concentrations were quantified using the picrosirius-hematoxylin histochemical method and further submitted to statistical analysis.
Website: https://www.selleckchem.com/products/tqb-3804-egrf-in-7.html
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