Our hospital comprises nine departments of internal medicine that specialize in different organs, and the Department of General Internal Medicine is one of these departments. The inpatient department has 30 beds for providing medical care, and education is provided for junior and senior residents. We examined the diagnoses in 593 cases (289 men, 304 women ; mean age, 64.2±21.2 years old) who were hospitalized in the Department of General Internal Medicine at this hospital between April 2007 and March 2008. The major diseases included pneumonia, 111 cases ; urinary tract infections, 44 cases ; infectious enteritis, 34 cases ; bronchial asthma, 24 cases ; fever of unknown origin, 12 cases ; heart failure, 11 cases ; viral infections 9 cases, diverticulitis, 8 cases ; malignant lymphoma, 7 cases ; infectious mononucleosis, 7 cases ; polymyalgia rheumatica, 6 cases ; and others. In order to provide diagnoses and treatments for cases in which no diagnosis could not be obtained on the first outpatient visit, for example, it is necessary to have a ward for general internal medicine as a location for providing medical care that is not limited to any specialized field.

BACKGROUND: Most studies have reported that suicide mortality rates are negatively associated with lithium levels in tap water; however, a few studies showed either no association or a positive association. Thus, the association between suicide mortality and lithium levels in tap water remains controversial. To clarify the association, our study evaluated the association between lithium levels in tap water and suicide mortality rates in Miyazaki Prefecture of Japan, after adjusting for confounding factors. METHODS: We measured lithium levels in tap water across the 26 municipalities of Miyazaki Prefecture in Japan. We examined the standardized mortality ratio (SMR) for suicide in each municipality and used the data as the average suicide SMRs over 5 years (2009-2013). Weighted least-squares regression analysis, adjusted for the size of each municipality's population, was used to investigate the association between lithium levels in tap water and suicide SMRs. In addition to a crude model, in an adjusted model, potential confounding factors (proportion of elderly people, proportion of one-person households, annual marriage rate, annual mean income, unemployment rate, the density of medical doctors per 100,000 people, annual total rainfall, and proportion of people with a college education or higher) were added as covariates. RESULTS: We showed that male and female suicide SMRs were not associated with lithium levels in tap water in Miyazaki Prefecture. After adjusting for confounders, male suicide SMRs were significantly and positively associated with the proportion of elderly people in the population and annual total rainfall, and female suicide SMRs were associated with the proportion of elderly people in the population. CONCLUSIONS No association between lithium levels in tap water and suicide mortality rates was found in Miyazaki Prefecture.
Drinking Water ; analysis ; Female ; Humans ; Japan ; Lithium ; analysis ; Male ; Suicide ; statistics & numerical data