ABSTRACT
Objective<br> The purpose of this study is to evaluate the differences in the reasons for visits to a Tokyo hospital before and after the changing of the name of the outpatient service from “internal medicine” to “general practice.” <br>Methods<br> The participants in this study were outpatients who visited the internal medicine department from September to October, 2006, and the general practice department from September to October in 2008, for their first medical examination at a hospital in Tokyo. <br>We encoded the reasons for the hospital visits using ICPC-2 (International Classification of Primary Care-2), and counted the number of reasons for each outpatient. <br>Results<br> In the internal medicine service, there were 362 outpatients participants (193 men and 169 women) with an average age of 48.6 years. In the general practice service, the participants consisted of 376 outpatients (206 men and 170 women) with an average age of 50.5 years. The difference between the total number of reasons for visits to the general practice service (1.7 ± 0.9 per visit) and to the internal medicine service (1.5 ± 0.8 per visit) was statistically significant. However, no significant differences were found between the two in terms of the proportion of the frequency for each category of reasons. <br>Conclusion<br> This study found that the changing of the name of the outpatient service from “internal medicine” to “general practice” led to a slight but statistically significant increase in the total number of reasons per visit. However, this change had no effect on the frequency for each category of reasons as a proportion of the total.
ABSTRACT
We performed a retrospective study of the effects of steroids and the factors that deteriorate renal function in 30 patients with primary focal segmental glomerular sclerosis. The mean observation periods from the onset of proteinuria and from the histological diagnosis by renal biopsy were 6.1 ± 5.0 years and 3.9 ± 3.01 respectively. 87% of the patients had been recerving steroid therapy with or without other drugs. In this study, the patients were divided into 3 groups by the initial dose of steroids. A multivariate analysis was performed on the laboratory findings of the 3 groups. In a short-term observation, there were no significant defferences among the groups. However, in a long-term observation (more than one year) it was clarified that the patients who had been given high doses of steroids tend to maintain their renal functoin. We also found that the patients responding to steroids showed a significantly better prognosis than steroid-resistant patients upon examination their nephrotic status and renal functoin.<BR>This statistical analysis confirmed that the factors deteriorating the renal function are hypertension and hyperlipidemia.<BR>In addition, it was revealed that hyperuricemia, is responsible for the renal dissease, failure?