General Medicine
Online ISSN : 1883-6011
Print ISSN : 1346-0072
ISSN-L : 1346-0072
Volume 12, Issue 1
Displaying 1-8 of 8 articles from this issue
Editorial
Special Article
Original Article
  • Keito Torikai, Nobuyoshi Narita, Takahide Matsuda, Yuko Tohyo, Fumihik ...
    2011 Volume 12 Issue 1 Pages 11-18
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
    OBJECTIVE: The present study assessed the validity of the benchmark, 75 years old, that divides elderly people into an early and a late stage, based on health checkup results for two consecutive years. We also investigated prevalent health problems and improvement trends.
    METHODS: This retrospective study was conducted on 1,416 subjects (1,007 early and 409 late elderly subjects) who received health checkups at the Health Care Center of the St. Marianna University School of Medicine Hospital between April 2006 and March 2007. The survey consisted of blood pressure, required blood test results, diagnoses according to the criteria defined by Kawasaki city, outcomes, and the presence or absence of a primary care doctor.
    RESULTS: The number of subjects with anemia and/or renal dysfunction was significantly greater in the late elderly than the early elderly (p<0.01). The results of the survey demonstrated that 79.6% of the early elderly and 87.4% of the late elderly had primary care doctors (p<0.01). In the early elderly, 57.0% of the subjects with primary care doctors and 43.2% of those without primary care doctors showed improvement; the subjects with primary care doctors showed significant improvement compared to those without primary care doctors (p<0.05). In the late elderly, 50.2% of the subjects with primary care doctors and 54.2% of those without primary care doctors showed improvement, resulting in no significant difference between the subjects with and without primary care doctors.
    CONCLUSIONS: We found differences in the detected health problems and outcomes between the early and late elderly. These results support the appropriateness of the current age segmentation and future prospects for medical care in detecting and managing health problems in the elderly.
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Case Reports
  • Akihiro Inui, Toshio Naito, Eiichiro Sugihara, Hiroshi Isonuma
    2011 Volume 12 Issue 1 Pages 19-23
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
    BACKGROUND: We describe a 40-year-old Thai woman living in Japan who was transferred to Juntendo University Hospital after lung cancer was suspected. Chest X-ray showed a nodular lesion and pleural effusion in the left lung. Laboratory data showed eosinophilia. She denied having consumed raw or undercooked food at the initial interview. Microplate enzyme-linked immunosorbent assay (ELISA) for Paragonimus westermani specific immunoglobulin (Ig) G antibody was positive at a high titer, confirming the diagnosis of P. westermani infection. She was successfully treated with oral praziquantel. All primary practitioners should be aware that paragonimiasis is an important pulmonary disease that can cause nodular lesions on chest X-ray.
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  • Masanori Shimodaira, Naoko Kumagai, Nobutaka Fujisawa
    2011 Volume 12 Issue 1 Pages 25-28
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
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  • Kentaro Iwata, Tomoko Toma, Akihiro Yachie, Hideaki Oka, Goh Ohji, Wat ...
    2011 Volume 12 Issue 1 Pages 29-31
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
    A 23-year old female was referred to our clinic for intermittent fever occurring over a period of eight years. Every time she developed fever, blood examination revealed elevated leukocytes and C-reactive protein (CRP). Antibiotics were always given based on elevated CRP with apparent improvement. However, the pattern of periodicity with absence of symptoms in between suggested periodic fever syndrome, particularly Familial Mediterranean Fever (FMF), which was later confirmed by mutation analysis. In Japan there is a tendency to use antibiotics solely based on "elevated CRP"; however, careful review of patient history is essential to identify FMF while avoiding the use of unnecessary antibiotics.
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  • Tomoyuki Koura, Keiichiro Kita, Hiroko Ejiri, Maiko Kuroiwa, Seiji Yam ...
    2011 Volume 12 Issue 1 Pages 33-34
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
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  • Ayako Basugi, Yoshiyuki Ohira, Masatomi Ikusaka
    2011 Volume 12 Issue 1 Pages 35-41
    Published: 2011
    Released on J-STAGE: July 05, 2011
    JOURNAL FREE ACCESS
    Objective : The outpatient diagnostic processes of novice and trained residents were compared, as to the working diagnosis time and the correct tentative diagnosis rate after history taking to the final diagnosis.
    Methods : Three physicians who had received outpatient training in our department for ≥2 years were defined as “trained residents”, and another three physicians participated in this study from their first day of training at the outpatient clinic were defined as “novice residents”. The study was done at Chiba University Hospital in Japan. The working diagnosis time was defined as the time for the physicians to make a tentative diagnosis for each patient based on history taking, and was calculated from the starting and ending times entered into a computer. By comparing the working diagnoses and the final diagnoses, the correct diagnosis rate was determined for each physician.
    Results : The correct diagnosis rates for trained residents were 87%, 87%, and 85%, respectively. These rates were significantly higher than those of novice residents, which were 73%, 69%, and 55%, respectively (all P<0.001). The working diagnosis times of trained residents were significantly shorter than those of novice residents (all P<0.001). The trained residents still made mostly correct diagnoses after a long time, while the novice residents made more wrong diagnoses as time passed.
    Conclusion : The working diagnosis time was shorter and the correct diagnosis rate was higher in the trained resident group than the novice resident group. Trained residents were able to eventually make a correct diagnosis, even when they failed to make the correct diagnosis initially. On the other hand, the correct tentative diagnosis rate was generally lower for novice residents, and the rate was markedly lower when patients had diseases that could not be diagnosed at an early stage.
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