Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
53 巻, 19 号
  • Yoshiya Morito, Masahito Aimi, Norihisa Ishimura, Shino Shimura, Hiron ...
    2014 年 53 巻 19 号 p. 2179-2183
    発行日: 2014年
    公開日: 2014/10/01
    ジャーナル オープンアクセス
    Objective Although gastroesophageal reflux disease (GERD) is known to cause sleep disturbances, the relationships between other abdominal symptoms and sleep disorders have not been clarified. In the present study, we examined the relationships between daytime sleepiness and various abdominal symptoms in a non-clinical population.
    Methods We enrolled 2,936 subjects who visited Matsue Red Cross Hospital for an annual health check examination during a 10-month consecutive period after excluding those with organic gastrointestinal diseases. The Izumo scale abdominal symptom and Epworth Sleepiness Scale (ESS) questionnaires were employed to evaluate the presence of abdominal symptoms and daytime sleepiness.
    Results Among the 2,936 subjects, 233 (7.9%), 254 (8.6%) and 528 (18%) had GERD-like, functional dyspepsia (FD)-like and irritable bowel syndrome (IBS)-like symptoms, respectively. The ESS scores in the subjects with GERD-, FD- and IBS-like symptoms were significantly higher than those observed in the asymptomatic subjects. The subjects with multiple abdominal symptoms tended to have higher ESS scores than those with single symptoms. A multiple logistic regression analysis revealed a younger age and the presence of FD- and IBS-like symptoms to be significant influencing factors for sleep disturbances.
    Conclusion The presence of FD and IBS symptoms in addition to GERD symptoms exhibits a strong relationship with sleep disturbances from the viewpoint of daytime sleepiness.
  • Tomomi Kinoshita, Ryu-ta Abe, Akiyo Hineno, Kazuhiro Tsunekawa, Shunya ...
    2014 年 53 巻 19 号 p. 2185-2200
    発行日: 2014年
    公開日: 2014/10/01
    ジャーナル オープンアクセス
    Objective To investigate the causes of neurological manifestations in girls immunized with the human papillomavirus (HPV) vaccine.
    Methods During the past nine months, 44 girls visited us complaining of several symptoms after HPV vaccination. Four patients with other proven disorders were excluded, and the remaining forty subjects were enrolled in this study.
    Results The age at initial vaccination ranged from 11 to 17 years, and the average incubation period after the first dose of the vaccine was 5.47±5.00 months. Frequent manifestations included headaches, general fatigue, coldness of the legs, limb pain and weakness. The skin temperature examined in 28 girls with limb symptoms exhibited a slight decrease in the fingers (30.4±2.6°C) and a moderate decrease in the toes (27.1±3.7°C). Digital plethysmograms revealed a reduced height of the waves, especially in the toes. The limb symptoms of four girls were compatible with the Japanese clinical diagnostic criteria for complex regional pain syndrome (CRPS), while those in the other 14 girls were consistent with foreign diagnostic criteria for CRPS. The Schellong test identified eight patients with orthostatic hypotension and four patients with postural orthostatic tachycardia syndrome. The girls with orthostatic intolerance and CRPS commonly experienced transient violent tremors and persistent asthenia. Electron-microscopic examinations of the intradermal nerves showed an abnormal pathology in the unmyelinated fibers in two of the three girls examined.
    Conclusion The symptoms observed in this study can be explained by abnormal peripheral sympathetic responses. The most common previous diagnosis in the studied girls was psychosomatic disease. The social problems of the study participants remained unresolved in that the severely disabled girls stopped going to school.
  • Umit Savasci, Nisa Cem Oren, Yasam Kemal Akpak, Gokcen Gokce, Kemal Te ...
    2014 年 53 巻 19 号 p. 2201-2204
    発行日: 2014年
    公開日: 2014/10/01
    ジャーナル オープンアクセス
    Objective It is commonly known that ultrasonography (US) transducers function as both a reservoir and means of transfer for hospital infections. The current study aimed to compare the antimicrobial effectiveness of using >80°C water versus antiseptic wipes to disinfect US transducers.
    Methods Subsequent to abdominal inspections in three groups of 20 patients, a swab culture was taken from the transducer in each case. Neither a mechanical nor chemical disinfection was applied to the transducer in the first group. As for the second group, the transducer was placed in >80°C hot water for five minutes. In the third group, the transducer was wiped clean using antiseptic wipes.
    Results Of the 60 swab samples collected, 40 did not produce any growth. The number of samples exhibiting growth in the first group involved 18 cases of coagulase-negative staphylococcus (CNS), as well as 15 cases of Listeria spp., one case of Corynebacterium spp. and one case of Bacillus spp., while only one case of CNS was observed in the second and third groups, respectively. The culture growth and colony forming units rate were significantly higher in the samples obtained from the first group than in those obtained from the other groups (p<0.01). As for the second and third groups, no significant differences were found in terms of the amount of colonization and growth (p=1.00).
    Conclusion Being a practical and a simple method for particular use in developing and underdeveloped countries, where it is hard to access relatively costly transducer disinfection materials, such as antiseptic wipes, hot water disinfection may play an active role in fighting hospital infections.
  • Sho Nishiguchi, Joel Branch, Yu Suganami, Izumi Kitagawa, Yasuharu Tok ...
    2014 年 53 巻 19 号 p. 2205-2210
    発行日: 2014年
    公開日: 2014/10/01
    ジャーナル オープンアクセス
    Objective Patients with urosepsis associated with urinary tract calculi occasionally require drainage, primarily via ureteric stenting. Such patients require longer hospitalization. However, the indications for early ureteric stenting for this condition have not been clearly defined. To compare the length of stay (LOS) in the hospital between patients treated with earlier ureteric stenting versus those with delayed ureteric stenting.
    Methods Design: Retrospective cohort study. Setting: An acute care teaching hospital in Japan. Measurement: Length of hospital stay in days.
    Patients Patients with urosepsis associated with urinary tract calculi.
    Results Among a total of 30 patients (mean age, 72; 13 men), the mean number of days from emergency room admission to ureteric stenting was 3.5 days (range, 1-14 days), and the overall mean LOS was 36 days (range, 8-102 days). The early stenting group (mean LOS, 21 days) had a significantly shorter LOS than the delayed stenting group (mean LOS, 50 days), with an adjusted beta coefficient of -26 days [95% confidence interval (CI), -46, -6].
    Conclusion In patients with urosepsis associated with urinary tract calculi, performing early stenting within two days of admission may reduce the LOS in the hospital.