Unresolved Palliative Care Needs of Elderly Non-Cancer Patients at Home: A Multicenter Prospective Study.

Introduction/objectives: There is growing consensus on the benefits of initiating palliative care early in the disease trajectory; however, palliative care needs for non-cancer patients remain to be elucidated. We investigated the trajectory of unresolved palliative care needs of non-cancer patients at home and explored associated factors.

Methods: We conducted a multicenter prospective cohort study of elderly non-cancer patients at home in Japan between Jan 2020 and Dec 2020.

Comparison of the prevalence and associated factors of hyperactive delirium in advanced cancer patients between inpatient palliative care and palliative home care.

Background: Hyperactive delirium is known to increase family distress and the burden on health care providers. We compared the prevalence and associated factors of agitated delirium in advanced cancer patients between inpatient palliative care and palliative home care on admission and at 3 days before death.

Methods: This was a post hoc exploratory analysis of two multicenter, prospective cohort studies of advanced cancer patients, which were performed at 23 palliative care units (PCUs) between Jan and Dec 2017, and on 45 palliative home care services between July and Dec 2017.

[Differential Diagnosis of Interstitial Pneumonia by Home Ultrasound Examination].

Background: Patients receiving home care present clinically diverse forms of chronic respiratory failure, for which it is difficult to establish a definite diagnosis. CT diagnosis requires the patient to be transported, and obtaining the blood test results for the serum maker KL-6 requires a few days. Nevertheless, with the widespread use of portable ultrasound devices, we can now make an immediate ultrasound diagnosis of the lung in the home care setting.

[Consideration of the Work Content of the Clinic Pharmacist and Its Usefulness].

"Medical teams"have been promoted in the home care setting. For the pharmacist, it is possible to maintain the safety and improve the quality of medical care by working with a multidisciplinary team. The arrangement of the pharmacist with the clinic is specified in Article 18 of the Medical Care Law, but there is no medical treatment fee for the clinic pharmacist.

[How to make sure a balloon-type gastrostomy replacement was made right by ultrasound].

With the spread of gastric fistula, there have been increased reports of catheter aberrant and fistula damage during the time of catheter exchange procedures. Therefore, it has been recommended that a diagnostic imaging or endoscopic gastrostomy should be employed to make sure a catheter exchange was properly done. However, it is difficult to enforce an inspection using an X-ray or endoscopy in the home care environment.

[Introduction of Rapidtip BNP and Rapidpia--a clinical significance of rapid measurement BNP for home medicine care].

Dyspnea is a common symptom, and a heart failure is one of the most important preferred diagnoses of dyspnea. But it is difficult to undergo ECG, US, or other examination to diagnose a heart failure at the patient home, especially in the case of such examination was needed quickly or frequently. Rapidtip BNP and Rapidpia were invented in order to measure BNP rapidly at the patient home, or in the physician's car.

Surgical treatment of pseudoaneurysm of the sinus of valsalva after aortic valve replacement for active infective endocarditis.

Pseudoaneurysm is an uncommon and serious complication of infective endocarditis (IE). It is often fatal because of its rapid progress, high rates of rupture and recurrence, and worsening effects on the systemic condition. We report the rare case of a patient who developed a pseudoaneurysm of the sinus of Valsalva two months after emergency aortic valve replacement for active IE.

Omental herniation through the esophageal hiatus mimics mediastinal lipomatous tumor.

A 61-year-old man with a mediastinal abnormal mass on computed tomography is presented. Sagittal sections of magnetic resonance imaging (MRI) clearly indicated the continuity of the fatty mass from the abdomen to the thorax. The diagnosis was an omental herniation through the esophageal hiatus during the operation.