Effectiveness of initiating advance care planning among older outpatients through intervention by physicians trained in a model discussion video: A randomized controlled trial.

Aim: This study aimed to assess the impact of a physician-led intervention on advance care planning (ACP) introduction among older outpatients using a model discussion video.

Methods: This prospective interventional study included Japanese general practice outpatients aged ≥65 years. All participants received an ACP leaflet.

Subcutaneous Chest Abscess Caused by Candida albicans Infection Following Laparoscopic Cholecystectomy in an Immunocompetent Patient: A Case Report.

Cases of subcutaneous abscess due to () infection are rare, even among immunocompromised patients. To our knowledge, there have only been eleven reports of such cases in adults, all of which presented with comorbidities of immunodeficiency, prior antibiotic administration, or skin breakdown following traumatic episodes or iatrogenic procedures. We report a rare case of a 42-year-old Japanese woman with a subcutaneous abscess due to  infection.

Abdominal Muscle Fasciculations and Amyotrophic Lateral Sclerosis Diagnosis in a Patient Unable to Perform Sit-Ups.

While performing sit-ups, a 70-year-old man was unable to lift his upper body. The abdominal skin reflex was absent, and abdominal ultrasonography showed intermittent, irregular, and localized muscle twitches of the abdominal muscles. Further, electromyography (EMG) detected widespread fasciculations.

Application of Point-of-Care Ultrasound Scanning for the Diagnosis of Perianal Abscess.

A sixty-year-old man with ulcerative colitis and polymyalgia rheumatica, for which he was receiving prednisolone, visited the emergency department complaining of a gradual worsening of pain in the right buttock. Physical examination revealed mild redness and tenderness at the right side of the anus. Ultrasound revealed an approximately 38-mm long, avascular subcutaneous collection with heterogeneous echogenicity in the tender region.

Comprehensive infection control measures prevent hospital-acquired severe acute respiratory syndrome coronavirus 2 infection: A single-center prospective cohort study and seroprevalence survey.

Background: Coronavirus disease (COVID-19) is associated with a high mortality rate in older adults; therefore, it is important for medical institutions to take measures to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. This study aimed to assess the risk of SARS-CoV-2 infection among healthcare workers (HCWs) and the effectiveness of infection control measures.

Methods: This study had a cross-sectional component and a prospective cohort component.

Anticoagulant Therapy for Frail Patients with Atrial Fibrillation.

The prevalence of atrial fibrillation (AF) increases with age, as does the proportion of patients with frailty. AF patients with frailty have a higher risk of stroke than those without frailty, and progressive frailty caused by stroke is also associated with a worse prognosis. Despite this, anticoagulant therapy tends to not be used in frail patients because of the risk of falls and bleeding complications.

A woman with adult-onset Still's disease and acute intestinal pseudo-obstruction.

Adult-onset Still's disease may cause intestinal pseudo-obstruction via a cytokine storm. Early diagnosis and treatment are the key for patient survival before the development of serious complications such as macrophage activation syndrome.

Point-of-care ultrasound for prompt diagnosis and treatment monitoring of acute epiglottitis.

A 72-year-old woman presented with a 1-day history of acute throat pain, hoarseness. On cervical ultrasonography (transverse view), the epiglottis was swollen with anterior-posterior diameter of 3.5 and 3.

The effectiveness of transcutaneous cervical ultrasonography for diagnosing peritonsillar abscess in a patient complaining of sore throat.

Peritonsillar abscess should be considered as a differential in patients presenting with fever, sore throat, and other cold-like symptoms. Point-of-care transcutaneous cervical ultrasound is effective for diagnosing peritonsillar abscess in place of computed tomography (CT) imaging. Tongue movement during ultrasound examination will help confirm the presence of anatomical lesions on tonsils, and comparing the affected and unaffected sides will improve proper diagnosis.

Spontaneous Pyogenic Spondylitis and Possible Infective Endocarditis Caused by Aggregatibacter actinomycetemcomitans.

Aggregatibacter actinomycetemcomitans, an etiological agent associated with periodontitis, endocarditis, and other infections, has rarely been implicated in spondylitis. A 70-year-old man with aortic valve replacement presented with a 4-month history of lower back pain and was diagnosed with spondylitis. Prolonged incubation of blood cultures and a biopsy yielded A.

"Tree-in-bud" opacities with false-positive Gaffky score and diffuse aspiration bronchiolitis.

We present a case of diffuse aspiration bronchiolitis (DAB) with a false-positive Gaffky score. "Tree-in-bud" opacities detected after aspiration should be considered DAB rather than mycobacterial infection.

Refractory aphthae in the epiglottis and supraglottic area due to Crohn's disease.

A 27-year-old woman complaining of persistent fever and sore throat was consulted. Examination of the laryngopharynx revealed multiple aphthous ulcers in the uvula, arytenoids, epiglottis, and laryngeal pyriform fossa. Crohn's disease was diagnosed by colonoscopy.

Presence of anti-transcriptional intermediary factor-1 gamma antibodies in a dermatomyositis patient with retroperitoneal cancer of unknown primary site.

A 71-year-old woman with dermatomyositis (DM) received glucocorticoid steroid (GCS) and tacrolimus treatment. Relapse of skin symptoms was observed after tapering the GCS dose, and the patient tested positive for anti-transcriptional intermediary factor-1 gamma (TIF1-γ) antibody. Examinations for malignancy were repeatedly performed.

Importance of actively suspecting intracranial hypotension with diagnostic imaging prior to lumbar puncture.

It is important to suspect intracranial hypotension based on distinctly frequent orthostatic headaches and diffuse dural hyperplasia. Lumbar puncture is a procedure prone to complications, especially in patients with already existing intracranial hypotension.

Fat ring sign and tumoral pseudocapsule sign in idiopathic mesenteric panniculitis complicated by protein-losing enteropathy.

A 66-year-old man complained of lower limb edema was diagnosed with mesenteric panniculitis because of fat ring sign and tumoral pseudocapsule sign on contrast-enhanced CT. Patient had edema due to protein-losing enteropathy associated with mesenteric panniculitis.

Giant cell arteritis manifested by chronic dry cough.

A 77-year-old man visited the hospital with a chronic cough persisting for 2.5 months accompanied with night sweats, weight loss (3.5 kg) and elevated C-reactive protein level.

Characteristics of gout patients according to the laterality of nephrolithiasis: A cross-sectional study using helical computed tomography.

Objective: To clarify the clinical and laboratory characteristics of nephrolithiasis in gout by computed tomography (CT).

Methods: In 350 gout patients, unenhanced CT was performed at the 1st visit to hospital. Calculus density spots exceeding 1 mm in diameter with a CT value >120 Hounsfield units in the kidneys were defined as kidney stones.