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音量 1, 問題 1 (2013)

症例報告

Bilateral Adrenal Histoplasmosis in an Immunocompetent Man

Rukhsana Parvin and Rafique Uddin AKM

Histoplasmosis is a deep fungal infection caused by Histoplasma capsulatum. It presents commonly with transient pulmonary infection but disseminated form can involve any system in the body. Adrenal gland is affected frequently in histoplasmosis but bilateral involvement is unusual. Adrenal histoplasmosis is also common in immunocompromised host. We report a case of bilateral adrenal histoplasmosis in an immunocompetent patient without any features of adrenal insufficiency. Histoplasmosis was diagnosed by fine needle aspiration cytology (FNAC) from adrenal gland. Patient was treated with itraconazole with good response and is currently under follow-up.

総説

The Choice of Home Blood Pressure Monitoring Device Matters: Differences between Three Commercial Monitors Used in Finnish General Practice

Juha P Varis and Ilkka Kantola

Objectives: The use of home blood pressure measurement in the follow-up of antihypertensive treatment is rapidly increasing. Published non-commercial comparisons or validation studies between different types of home monitors have been rare. We describe here the results from a study in which three home blood pressure monitors from two manufacturers were compared.

Methods: Three different upper arm automatic blood pressure measuring devices: Microlife BP 3AC 1-1,
Microlife BP3AG1 and Omron M4-I were compared in a randomized study. It was carried out among 65 Finnish normo- and hypertensive people who used all three devices at home for one-week of blood pressure monitoring and measured their blood pressure twice both in the morning and in the evening.
Results: An about 2 mm Hg difference in systolic, diastolic and mean pressure was observed between Omron M4-I and the Microlife devices whereas the Microlife devices showed equal performance. A significant correlation in the mean pressure was observed between all three devices.

Conclusions: Although all these devices have passed the British Hypertension Society (BHS) qualification, the blood pressure monitoring results in this study showed that there may be a small blood pressure difference between the devices from separate manufacturers. Blood pressure monitoring results are most reliable when the same device is used consistently.

総説

Congenital Muscular Torticollis: An Overview

Antonios G Angoules, Eleni C Boutsikari and Eleni P Latanioti

Congenital Muscular Torticollis (CMT) is a congenital deformity characterized by unilateral shortening of the sternocleidomastoid muscle resulting in lateral inclination of the neck associated with contralateral torsion. It is a relatively common infantile deformity associated with typically favourable prognosis when early detected and treated. Although stretching exercises is still the most common treatment, this therapeutic approach should be applied early in younger subjects to be efficient. Surgical intervention is guaranteed before an established craniofacial asymmetry. The purpose of this is to provide an overview of the current therapeutic approaches with additional analysis of their effectiveness.

総説

The Busy General Practitioner Practitioner’s Reference Guide to Increasing Physical Activity Levels in the British Population and Associated Benefits/Risks: A Review of the Literature

Phil Cox

Whilst most General Practitioners (GPs) recognise the importance that physical activity plays in a healthy nation, many feel unprepared to provide physical activity counseling. GPs therefore do not routinely include physical activity in the consultation as readily as alcohol or tobacco, despite inactivity having a similar health burden. This review of relevant literature using Embase, SPORTDiscus, PubMed, and the Cochrane Library intends to refresh GP’s knowledge regarding the vast benefits of physical activity and to investigate the evidence concerning the risks physical inactivity. In addition, an evaluation of the efficacy of interventions to increase PA levels will be undertaken.

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