Characteristics in patients with headache in an outpatient clinic in Japan

<p>Abstract</p> <p>Background</p> <p>Little is known about the prevalence of primary and secondary headache in clinics in Japan. The aim of this study is to characterize patients with headache in an outpatient unit where primary care physicians are working in Japan.</p> <p>Methods</p> <p>Consecutive outpatients who newly visited the Department of General Medicine, Asahikawa Medical College Hospital, Asahikawa, Japan between April 2005 and March 2009 were analyzed. Each parameter such as age, sex or diagnosis was investigated.</p> <p>Results</p> <p>Out of 4693 patients, 418 patients visited to our department because of headache. Primary headache was found in 167 patients (39.9%). The rate of tension-type headache (TTH) (30.8%) was highest, followed by migraine (9.1%). Approximately 3 times higher rate of migraine was observed in female patients when compared with male patients. In female patients, migraine was observed more frequently in younger patients. On the other hands, TTH was observed in almost all aged patients in males and females, and the rate of TTH peaks between the ages of 40 and 49 years in both sex. The present study also demonstrated that 8.4% of patients who chiefly complained of headache had been diagnosed as depression while 1.7% of remained patients had been diagnosed as depression, indicating 5-times higher rate of depression in patients with headache.</p> <p>Conclusion</p> <p>All these results suggest that primary headache, especially TTH, is highly observed and depression should be considered in patients with headache in an outpatient clinic where primary care physicians are working in Japan.</p

The rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a clinic where primary care physicians are working in Japan

We analyzed the rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, both characterized as seronegative inflammatory arthritis in elderly, in an outpatient unit where primary care physicians are working in Japan to better understand the epidemiological characteristics of the diseases in Japan. Consecutive outpatients who newly visited at Department of General Medicine, Asahikawa Medical University Hospital, Japan, between April 2004 and March 2010 were analyzed. Each parameter such as age, sex, diagnosis, and biochemical examination was investigated. During the 6 years, 10 or 3 patients were diagnosed as PMR or RS3PE syndrome, respectively. The patients with PMR were 7 women and 3 men, and the average age at diagnosis was 69. Out of all patients aged over 50 (n = 3,347), the rate of PMR was 0.22% in men or 0.36% in women, respectively. On the other hand, RS3PE syndrome was diagnosed in 3 men (76, 76, and 81 years old). The rate of patients with RS3PE syndrome was 0.09% among outpatients aged over 50 indicating that the rate of PMR in an outpatient clinic in Japan is not far from previous findings reported from western countries. When compared with PMR, the rate of RS3PE syndrome was approximately one-third, providing for the first time the rate of RS3PE syndrome when compared with PMR. These epidemilogical data might help us pick up the diseases in primary care setting in Japan

A higher frequency of lumbar ossification of the posterior longitudinal ligament in elderly in an outpatient clinic in Japan

PublisherPURPOSE: Little is known about the prevalence and epidemiological characteristics of lumbar ossification of the posterior longitudinal ligament (OPLL). We analyzed the rate of lumbar OPLL in an outpatient unit where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease. METHODS: We analyzed consecutive, first-time visiting outpatients who received abdominal and pelvic computed tomography (CT) scan at the Department of General Medicine, Asahikawa Medical University Hospital, Japan, between April 2009 and March 2012. Each parameter such as age, sex, and clinical presentation was investigated. RESULTS: Out of 393 patients who underwent abdominal and pelvic CT scan, 33 (8.4%) were diagnosed as lumbar OPLL. When compared with patients without lumbar OPLL (n = 360), there was no significant difference in gender, body mass index (BMI), presence of hypertension, diabetes mellitus or hyperlipidemia, and smoking habit, while the age in patients with lumbar OPLL was significantly higher. CONCLUSION: These results suggest for the first time that lumbar OPLL is frequently observed in elderly people in the primary care setting, in Japan

Screening for major depressive disorder with the Patient Health Questionnaire (PHQ-9 and PHQ-2) in an outpatient clinic staffed by primary care physicians in Japan: a case control study.

The Patient Health Questionnaire (PHQ-9) is a self-report questionnaire commonly used to screen for depression, with ≥8-11 generally recommended as the cut-off. In Japan, studies of the validity of the PHQ-9 and PHQ-2 have been limited. In this study, we examined the utility of the PHQ-9 and PHQ-2 at an outpatient clinic in a Medical University Hospital in Japan.New consecutive outpatients were included in the study. We administered the PHQ-9 to 574 patients, and acquired complete PHQ-9 and PHQ-2 data for 521 patients. Major depressive disorders were diagnosed according to the DSM-IV-TR.Forty-two patients were diagnosed with major depressive disorders. The mean PHQ-9 (15.7) and PHQ-2 (3.8) scores of the patients with major depressive disorders were significantly higher than the scores of the patients without depression (6.0 (PHQ-9) and 1.8 (PHQ-2)). The best cut-off points for the PHQ-9 and PHQ-2 summary scores were ≥11 (sensitivity 0.76, specificity 0.81) and ≥3 (sensitivity 0.76, specificity 0.82), respectively. No relationship was observed between the age and PHQ-9 scores.The PHQ-9 and PHQ-2 were useful instruments for screening for major depressive disorders. The best cut-off point for the PHQ-9 summary score should be ≥11 to detect depression in the primary care setting in Japan

Prevalence of functional dyspepsia in an outpatient clinic with primary care physicians in Japan (日本における、総合外来での機能性消化不良症の罹患率)

著者最終原稿版機能性胃腸障害(FGID)、なかでも特に機能性消化不良症(FD)の頻度を明らかにする目的で、2004年4月から2009年3月までの連続した一般内科初診患者5183例を対象として検討を行った。5813例中、818例(14.1%)が腹部症状のための受診であった。これらの症例の最終診断は、FGID(320例、39.1%)、器質的消化器疾患(237例、28.9%)、器質的非消化器疾患(135例、16.5%)、その他(126例、15.4%)であった。FGIDの320例中、FDが170例、過敏性腸症候群(IBS)が68例、他のFGIDが88例であった。FGIDおよびFDの全症例に対する頻度はそれぞれ5.5%、2.9%であった。上腹部症状を訴えた外来患者381例中約45%がFDであった。FGID、FD、IBSの罹患率にはどの年齢層においても性差は認められなかった。70歳以上の女性ではFDの頻度が低く、29歳未満の男性にIBSが多かった。日本の初診外来においてFGID、特にFDの頻度が高いことが示された

Prevalence of functional dyspepsia in an outpatient clinic with primary care physicians in Japan

http://dx.doi.org/10.1007/s00535-009-0168-xBackground : Since little is known about the prevalence of patients with functional gastrointestinal disorders (FGID), this study was performed to clarify the prevalence of FGID, especially functional dyspepsia (FD), in new patients of an outpatient clinic with primary care physicians in Japan. Methods : We analyzed consecutive outpatients (n = 5183) who first visited the Department of General Medicine, Asahikawa Medical College Hospital, between April 2004 and March 2009. Results : Out of 5813 patients, 818 (14.1%) visited because of abdominal symptoms. Final diagnoses of the 818 patients were FGID (n = 320, 39.1%), organic gastrointestinal diseases (n = 237, 28.9%), organic non-GI disease (n = 135, 16.5%), and others (n = 126, 15.4%). The 320 patients with FGID had FD (n = 170), irritable bowel syndrome (IBS) (n = 68), and other FGIDs (n = 88). The rate of FGID or FD in all patients was 5.5% or 2.9%, respectively. Among outpatients (n = 381) who complained of upper abdominal symptoms, approximately 45% had FD. There was no gender difference in the frequency of FGID, FD, or IBS in all ages of patients. A lower incidence of FD was shown in female patients over 70 years old and a higher incidence of IBS in male patients under 29 years old. Discussion : These results suggest that the prevalence of FGID, especially FD, is very high in an outpatient clinic with primary care physicians in Japan

High rate of smoking in female patients with Mondor's disease in an outpatient clinic in Japan

PublisherPURPOSE: Little is known about the epidemiology of Mondor's disease. The aim of this study was to analyze the clinical features of Mondor's disease in an outpatient clinic where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease. PATIENTS AND METHODS: The data for consecutive outpatients who were new visitors to the Department of General Medicine in the teaching hospital (Asahikawa Medical University Hospital) at Asahikawa Medical University, Asahikawa, Hokkaido, Japan, between April 2004 and March 2012 were analyzed. Parameters such as age, sex, diagnosis, and clinical presentation were investigated. RESULTS: During the 8-year period covered in this study, six (0.07%) out of 8767 patients were diagnosed as having Mondor's disease. All of these patients with Mondor's disease were female, and the mean age was 41 plus or minus 12 years; the overall rate of Mondor's disease in all female patients involved in this study was 0.12%. The patients complained of pain and a cord-like structure in the anterolateral thoracoabdominal wall. The painful mass had persisted for 1-4 weeks before presenting at the Department of General Medicine and it disappeared within a couple of weeks. Current smoking was significantly higher in the patients with Mondor's disease than in the age-matched female patients without Mondor's disease who were also evaluated in this study. CONCLUSION: These results suggest that a high rate of smoking in middle-aged females may be a characteristic feature of Mondor's disease. These epidemiological data may be useful in detection of the disease in the primary care setting in Japan