A Case of Graves' Disease That Was Misdiagnosed as Thyrotoxic Crisis because of Chronic Bromvalerylurea Intoxication / 日本プライマリ・ケア連合学会誌

A woman in her 50s presented to the hospital with a chief complaint of headache and nausea. Graves' disease was diagnosed based on positive blood test results for thyrotoxicosis and TSH receptor antibody and ultrasonographic thyroid gland findings. The patient was hospitalized and started treatment with thiamazole; however, after hospitalization, psychiatric symptoms, such as visual and auditory hallucinations, appeared, and she fulfilled the diagnostic criteria for thyroid crisis. We increased the dose of thiamazole and added potassium iodide. Thyroid function improved; however, the patient experienced reemergence of psychiatric symptoms. Blood tests revealed pseudohyperchloremia, which led to the discovery of abuse of over-the-counter analgesics containing bromwarelyl urea. The psychiatric symptoms were suspected to be due to withdrawal from chronic bromine intoxication. After starting psychotropic drugs, the patient's psychiatric symptoms became mild, her thyroid function continued to improve steadily, and she was discharged from the hospital. Thyroid crisis is a condition that should be suspected and treated at an early stage; however, the diagnostic criteria for thyroid crisis can be false-positive if the thyroid disease is accompanied by other conditions that cause psychiatric symptoms.

A study of participants' evaluation of the supportive functions in community-based selfhelp groups for cancer survivors and the related factors

<b>Objective</b>: The reliability and validity of a scale to evaluate the supportive functions of community-based self-help groups (SHGs) for cancer survivors, which was named the Evaluation of Supportive Functions Scale (ESFS) was investigated. Moreover, factors related to the evaluation of supportive functions were identified. <b>Methods</b>: An anonymous, self-administered survey comprised of items related to the background, evaluation of supportive functions of SHGs, and participation status (frequency of participation, satisfaction with participation, and types of activities undertaken) was conducted with members of SHGs for cancer survivors (n=1,350). Valid responses (573 valid responses, 42.4%) were analyzed and ESFS was developed based on the responses. <b>Results</b>: The 21-item ESFS had excellent internal consistency. Factor analyses revealed a 4-factor solution of internally consistent subscales: Learning, Helping each other, Social involvement and Catalyst for personal growth. There was a significant relationship between participants' evaluation of supportive functions of SHGs with gender, role in the SHGs and type of cancer. The subscales were significantly related to the frequency of participation, satisfaction, and the type and range of activities that were undertaken. <b>Conclusions</b>: ESFS can measure participants' recognition of the utility of SHGs. We have discussed the practical applications of the scale as a tool for measuring the effectiveness of SHGs.

The relations between supportive functions of community-based self-help groups for cancer survivors and benefit findings

<b>Purpose</b>: The aim of this study was to examine the effects of community-based self-help groups for cancer survivors form supportive functions and benefit findings. <b>Methods</b>: A survey consisting of two scales was conducted with a sample of 109. The first scale measured the benefit finding in cancer experience, and the second scale measured supportive functions of self-help groups. <b>Results</b>: Exploratory factor analyses indicated that “benefit finding scale” included four factors, and the supportive functions of self-help group could be classified into four aspects. Benefit findings were related to the supportive functions. <b>Conclusion</b>: These results imply that the participation in self-help group is related to positive cognition of cancer survivors.