Seirei Sakura Citizen Hospital

Introduction: Patient-facing websites operated by medical societies are crucial for disseminating reliable health information; however, their real-world usage and effectiveness are often unquantified. This study investigated the user engagement and demographics of "Scoliosis Town," a patient education website developed by the Japanese Scoliosis Society, to evaluate its performance.

Abstract Background This study investigated the prevalence of presenteeism and its associated factors in employed patients undergoing maintenance hemodialysis (HD). Methods A single-center cross-sectional study was conducted involving 33 employed HD patients in Japan. Presenteeism was assessed using the work functioning impairment scale (WFun). Additional evaluations included hemoglobin (Hb) levels, exercise self-efficacy (SE), physical function (grip strength, 10-m walk test, and the short physical performance battery [SPPB]), and dialysis-related parameters. Correlation and multiple regression analyses were performed to identify independent predictors. Results Presenteeism was present in 39.4% of participants. WFun scores showed significant negative correlations with Hb levels, exercise SE scores, and SPPB scores. Multiple regression analyses revealed that lower Hb and SE scores were independently associated with higher WFun scores after adjustment for covariates. Conclusions Presenteeism in HD patients is linked to anemia and low exercise SE. Addressing these factors may support continued employment.

The incidence of inflammatory bowel disease (IBD) is rising in newly industrialized nations, yet nationally representative data from Türkiye are limited. We characterized recent epidemiologic trends, clinical features, and geographic distribution of newly diagnosed IBD across Türkiye. This retrospective multicenter cohort included adults (≥18 y) with newly diagnosed IBD at 24 gastroenterology centers spanning all 7 Turkish regions (2010-2022). Demographics, disease behavior/extent, smoking status, family history, and province of residence were collected. Temporal and regional patterns were analyzed using χ2 tests and segmented regression. Among 3463 patients, 51.1% had UC, 44.0% CD, and 0.7% IC. Males comprised 57.7%; median age at diagnosis was 30 years for CD and 32 years for UC. Annual IBD diagnoses more than doubled from 2010 to 2021. The UC-to-CD ratio increased from 0.94:1 (2010-2016) to 1.29:1 (2016-2022, P < 0.001). CD most often showed inflammatory behavior (55.5%) and ileocolonic involvement (37.1%); UC frequently presented as pancolitis (39.3%). Smoking (24.2% vs 10.9%) and family history (6.8% vs 4.5%) were more common in CD than UC (both P <0.01). Choropleth mapping revealed a west-to-east gradient, with Marmara and Aegean regions bearing the highest burden. Multivariable analysis showed UC diagnosis was independently associated with state-hospital care, residence in Central Anatolia or the Black Sea, and age ≥60 years. Incident IBD in Türkiye has risen steadily, with UC now exceeding CD. Patients predominantly present in early adulthood. Regional and hospital-level differences highlight the need for a national registry and targeted resource allocation.

Aim: The aim of this study is to investigate the relationship between statin use and deep vein thrombosis (DVT). Material and Methods: Between 2022 and 2024, 1833 patients (926 males; mean age 50.2±0.37 years) who applied to our clinic were included in the study. Following exclusion criteria, the patients were divided into two groups. Group A (n=226): patients diagnosed with DVT, and Group B (n=1607): Patients without DVT. Then, patients diagnosed with DVT (n=226) were divided into two separate subgroups. Group C (n=16): Statin users, and Group D (n=210): statin non-users. Comparisons were made between these groups in terms of demographic data, comorbidities, statin usage, laboratory parameters, and DVT localizations. Results: Statin usage was significantly lower in the DVT group than in the non-DVT group (16 (7.1%) and 184 (11.4%), respectively, p=0.04). In Group C, the incidence of DVT in the superficial femoral vein was higher than in Group D (p=0.03). Although no statistically significant difference was found, the incidence of DVT in the iliac veins was higher in Group D, while the incidence of DVT in the common femoral vein was higher in Group C. Similarly, rare localizations of DVT are more frequent in Group D than in Group C. DVTs in statin non-users tended to be more widespread than in statin users. A negative significant association was found between statin usage and DVT (p=0.001, OR= -0.084 [95% CI, -0.123–0.036]. Conclusion: We determined that statin usage was lower in patients with DVT than in those without DVT. Statin usage may be protective against DVT. Although no statistically significant difference was found, DVTs in statin non-users tended to be more widespread than in statin users. We found that DVTs in statin non-users affected more proximal segments, whereas in statin users, more distal venous segments were affected.

Early anal canal cancer is frequently treated with endoscopic submucosal dissection (ESD) to preserve anal function. However, if the lesion is in the anal canal, then significant difficulties such as bleeding and challenges associated with scope manipulation can arise. A 70-year-old woman undergoing follow-up after transverse colon cancer surgery was diagnosed with anal canal cancer extending to the dentate line. The patient underwent a combination of ESD and transanal resection (TAR). The specimen was excised in pieces, which resulted in difficulty performing the pathological evaluation of the margins, especially on the anal side where TAR was performed and severe crushing was observed. Careful follow-up was performed, and local recurrence was observed 3 years postoperatively. Because the patient had superficial cancer without lymph node metastasis, local resection was performed again. The second treatment attempt was improved as follows: (1) TAR and ESD were performed appropriately based on the situation by the same physician; (2) A needle scalpel was used during TAR to prevent tissue crushing; and (3) The lesion borders were marked using ESD techniques before treatment. Complete resection was performed without complications. Anal canal lesions can be safely and reliably removed when ESD and TAR are used appropriately.

Abstract Purpose Duchenne muscular dystrophy (DMD) is a severe, progressive condition characterized by muscle degeneration and weakness, significantly affecting respiratory function. This study aimed to evaluate the presence of sleep-disordered breathing (SDB) in children with DMD and investigate the relationships between sleep and respiratory function using spirometry, sniff nasal inspiratory pressure (SNIP), and polysomnography (PSG) along with capnography.Research Question: Can low SNIP be a guide for detecting respiratory muscle involvement early and determining the right time to perform early PSG and capnography in DMD?Study Design: Prospective, observational, cross-sectional study.Methods This study included DMD patients aged &lt; 18 years. Pulmonary function tests were conducted using spirometry and SNIP, and maximum inspiratory and expiratory pressure were measured. PSG and capnography were performed within two weeks after the pulmonary function tests, and their relationships with each other were investigated.Results The study included 44 children. Obstructive sleep apnea syndrome (OSAS) was present in 70.5% of patients, while nocturnal hypoventilation was observed in 4.5%. SNIP values were significantly lower in patients with moderate-to-severe OSAS than in those without OSAS. An SNIP value below 40 cm H2O was associated with a 92.8% prevalence of OSAS.Conclusion SNIP is a valuable, noninvasive marker for the early detection of respiratory muscle involvement and SDB in patients with DMD. This study highlights the need for early and regular respiratory monitoring in children with DMD to enhance care and quality of life.