A Case of Dermatomyositis with Severe Myalgia and Muscle Weakness Testing Positive for Anti-melanoma Differentiation-associated Gene 5 Antibody.

We report a case of a woman with typical dermatomyositis (DM) with skin manifestations, severe myalgia and muscle weakness complicated by interstitial lung disease (ILD) and pneumomediastinum. Pneumomediastinum persisted despite treatment with immunosuppressive therapy (steroids and cyclosporine). After the test for anti-melanoma differentiation-associated gene 5 (MDA5) antibody came out positive, we doubled the cyclosporine dose and her condition improved. Despite typical clinical features of DM, in cases complicated by pneumomediastinum or steroid resistance, measurement of anti-MDA5 antibody may be useful for immunosuppressant dose titration.

Severe Hypomagnesemia Associated with the Long-term Use of the Potassium-competitive Acid Blocker Vonoprazan.

Hypomagnesemia caused by a proton pump inhibitor (PPI) was first reported in 2006. We herein report a case of hypomagnesemia due to the long-term use of vonoprazan, a potassium-competitive acid blocker (P-CAB). A 66-year-old man was admitted to our hospital complaining of disturbance of consciousness with evidence of hypomagnesemia noted on blood testing. The long-term use of vonoprazan was considered the cause of his hypomagnesemia, so it was discontinued, after which the hypomagnesemia improved. Hypomagnesemia can be induced not only by PPI treatment but also following the long-term use of P-CAB.

Influence of a community-based approach to improve risk factors of lifestyle diseases by Japanese public health nurses: A case-control study.

BACKGROUND AND OBJECTIVES: It is important to examine the roles of specific health check-up and specific health guidance in individuals at high risk of common lifestyle diseases, but evaluation based on a stratified analysis of people undergoing a health check-up has not been adequately performed. In this study, we examined the effects of providing specific health guidance to individuals considered at high risk for a lifestyle disease after specific health check-ups. METHOD: Subjects who underwent a specific health check-up in 2012 were assigned to either a group that received health guidance from public health nurses over three years (n = 393) or a control group (n = 109). Clinical findings of both groups were analysed to evaluate the correlation between their changes and health guidance. RESULTS: A significant decrease was observed in blood pressure, and lipid and glucose levels only in the health guidance group. Multiple regression analysis revealed that health guidance was the explanatory variable of serum lipid improvement. DISCUSSION: Continued support by Japanese public health nurses through health guidance closely related to the subject's lifestyle over three years may lead to a comprehensive reduction in the risk of lifestyle diseases.