小佐見 光樹

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.

Uric acid, the final product of purine metabolism, plays a significant role in hypertension Research on uric acid has advanced significantly, particularly regarding its links to hypertension and cardiovascular disease (CVD). Our 2023 review covered the relationship between uric acid, hypertension; and CVD, however, numerous new studies have emerged since then. This paper provides an update, summarizing recent findings over the past two years on hyperuricemia and its association with hypertension, preeclampsia, arteriosclerosis, kidney disease, sleep-disordered breathing, CVD, and so on. Hyperuricemia, often driven by reduced uric acid excretion or increased production, is influenced by genetic factors and lifestyle habits, including high-purine foods, alcohol, and fructose intake. While hyperuricemia has been proposed to contribute to hypertension and CVD through mechanisms like inflammasome activation and oxidative stress, its causal role remains debated. Further clinical and basic science studies on hyperuricemia and purine metabolism are necessary to clarify its impact on CVD and guide therapeutic approaches.