小佐見 光樹

BACKGROUND: We investigated the association between the development of sarcoidosis and personal or family medical history, with a focus on immune-mediated inflammatory diseases (IMIDs), in a Japanese population. METHODS: In this exploratory case-control study, self-administered questionnaires were completed by 164 patients with newly diagnosed sarcoidosis (64 men, 100 women) who visited public health centres in 7 prefectures between 2018 and 2020 to apply for medical expense subsidies (cases) and by 1779 community-dwelling controls (641 men, 1138 women) undergoing municipal health checkups (controls). The questionnaire collected information on personal and family medical histories, including IMIDs. Logistic regression analyses adjusted for age and sex were used to identify risk factors associated with onset of sarcoidosis. RESULTS: A history of IMIDs was associated with a greater likelihood of sarcoidosis (adjusted odds ratio [aOR] 3.05, 95 % confidence interval [CI] 1.79-5.21). Increased risk was observed for rheumatoid arthritis (aOR 2.63, 95 % CI 1.06-6.53), Sjögren's syndrome (aOR 14.39, 95 % CI 4.30-48.10), and hypothyroidism (aOR 4.91, 95 % CI 2.20-10.97). Some conditions, such as asthma, lymphoma, and insulin use, showed possible associations, with wide CIs including 1.0. Additionally, a family history of sarcoidosis was strongly associated with disease occurrence (aOR 21.30, 95 % CI 3.86-117.68), supporting a potential genetic predisposition consistent with previous epidemiological findings. CONCLUSIONS: This study suggests that sarcoidosis may be associated with IMIDs in the Japanese population. However, its findings should be interpreted with caution, given its exploratory design and limited statistical power.

OBJECTIVE: This study examined the barriers to writing case reports among Japanese physicians who participated in a web study series titled "Let's Write a Case Report! What you need to do to be Accepted" and explored differences in these barriers based on physicians' years of experience. METHODS: The study design was cross-sectional in nature. Throughout August and November 2020, the respondents participated in the web study sessions. Using an 11-point scale, from -5 (not a barrier at all) to 0 (neither) to 5 (very much of a barrier), the 16 items interrogated which elements could be barriers to case report writing. Participants were divided into two groups: those with 10 or fewer years of postgraduation experience and those with 11 or more years of postgraduation experience. The basic attributes and possible barriers were compared between the groups using chi-squared and t-tests. RESULTS: In total, 53 (62.4%) participants responded to the web-based questionnaire. In a comparison between the two groups, the following barriers were significantly higher in the 10 years or fewer group: having sufficient medical documentation to write a report, knowing how to write a case report, determining the main case points and clinical message, knowing how to search the literature, knowing how to obtain literature, meeting the financial cost of accessing literature. Although there were no significant differences, only the lack of motivation to write papers was perceived as a barrier by the 11 years or more group. CONCLUSIONS: Determining the main case points and clinical message, selecting an appropriate journal for submission, and having adequate time to write a paper were the major barriers to writing a case report. Paper-writing motivation was crucial for those with longer clinical experience and experience in writing papers. These barriers were significantly more pronounced among those with fewer than 10 years of clinical experience than among those with 11 or more years of experience. Providing targeted support in developing case points and clinical messages will lead to an increase in the rate of case report writing.