The Clinical Significance of Anaerobic Coverage in the Antibiotic Treatment of Aspiration Pneumonia: A Systematic Review and Meta-Analysis.

Introduction: Aspiration pneumonia is increasingly recognised as a common condition. While antibiotics covering anaerobes are thought to be necessary based on old studies reporting anaerobes as causative organisms, recent studies suggest that it may not necessarily benefit prognosis, or even be harmful. Clinical practice should be based on current data reflecting the shift in causative bacteria.

The release of phosphorylated-HSP27 from activated platelets of obstructive sleep apnea syndrome (OSAS) patients.

Background: Obstructive sleep apnea syndrome (OSAS) is a well known risk of arterial thrombosis that results in cardiovascular morbidity. It has been reported that platelet aggregability is enhanced in patients with OSAS. In the present study, we investigated whether phosphorylated-HSP27 is released from the activated platelets of OSAS patients.

Validity of Total Kihon Checklist Score for Predicting the Incidence of 3-Year Dependency and Mortality in a Community-Dwelling Older Population.

Objectives: To validate the ability of the total Kihon checklist (t-KCL) score to predict the incidence of dependency or death within 3 years in a community-dwelling older population.

Design: Population-based longitudinal observational study.

Setting: Town of Higashi-ura, Japan.

A case of pulmonary actinomycosis diagnosed by transbronchial lung biopsy.

A previously healthy 73-year-old man was hospitalized with left complicated effusion and a consolidation in the left upper lung. He underwent a chest tube insertion and was treated with clindamycin but the consolidation remained after the treatment. We subsequently performed flexible bronchoscopy but it was impossible to make a diagnosis.

Validity of the Kihon Checklist for assessing frailty status.

Aim: The Kihon Checklist is extensively used in Japan to identify elderly persons who are at risk of requiring support/care. We aimed to determine whether or not the Kihon Checklist can estimate frailty status defined by the Cardiovascular Health Study criteria.

Methods: This cross-sectional study evaluated the Kihon Checklist and activities of daily living based on self-records maintained with the assistance of nurses in a convenience sample of 164 elderly outpatients who lived without care or support.

[Palliative care in patients without cancer: Impact of the end-of-life care team].

Palliative care improves the quality of life of patients and their families facing problems associated with life-threatening illnesses by promoting the prevention and relief of suffering. Palliative care in Japan has been developed mainly for cancer patients. At the National Center for Geriatrics and Gerontology, an end-of-life care team (EOLCT) has been developed to promote palliative care for patients without cancer.

[Usefulness of support from end-of-life care teams in difficult decision-making].

It is unclear how hospitals should support a patient's decision to return home to die. Thus, we retrospectively examined the usefulness of support from an End-Of-Life Care Team in such difficult decision making. The subjects included non-cancer patients and the elderly.

[Comprehensive geriatric assessment and cancer care-choice of treatment and in-home palliative care executed by using advance care planning].

Choice of treatment and in-home palliative care are important for the cancer care of the elderly. In recent years, comprehensive geriatric assessment (CGA), which has been developed as a multidimensional evaluation method for the elderly, has been attracting attention for cancer care as well. CGA can be a common language for the choice of treatment and in-home palliative care of elderly cancer patients.

[Role of home medical care support system in aged cancer patients' symptom relief and regional alliances].

The aim of this study was to evaluate the role of home medical care support system to relieve the symptom and regional alliances for elderly cancer patients. We investigated clinical parameters to study the features of this system. The home medical care support system is designed for patients who are B75-year-old with decrease in activities of daily living and severe dementia.

Screening for methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to a geriatric hospital.

Our objective is to identify risk factors for carriage of MRSA on admission to a geriatric hospital where MRSA is endemic. A prospective screening for MRSA carriage was conducted by swabbing anterior nares and anal skin for 6 weeks. One hundred and thirty-eight patients aged over 65 were enrolled after obtaining their informed consent.

Surgical site infection in living-donor liver transplant recipients: a prospective study.

Background: Infection is a constant threat for the living-donor liver transplantation (LDLT) recipients, although little information is available on the occurrence of infection in such patients.

Methods: One hundred and thirteen consecutive LDLT recipients were prospectively followed for the presence of surgical site infections (SSIs) defined by CDC from April 2001 to March 2002. Risk factors for SSIs were evaluated by univariate and multivariate analysis.

Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study.

Background: The aim of the present study was to assess the usability and efficacy of our new protocol of prophylactic antibiotic use to prevent perioperative infection in urological surgery.

Methods: We prospectively investigated 339 cases of typical urological surgery in our department between April 2001 and March 2002 (group I). We classified surgical procedures into four categories by invasiveness and contamination levels: category A, clean less invasive or endoscopic surgery; category B, clean invasive or clean contaminated surgery; category C, urinary tract diversion using the intestine; and category D, infected surgery.

Detection of bacteria and fungi in BacT/Alert standard blood-culture bottles.

Incubation periods of aerobic (AE) and anaerobic (AN) blood-culture bottles with the BacT/Alert system were assessed in our laboratory. We reviewed the results of 6229 blood-culture sets collected at Kyoto University Hospital from January 1999 to December 2000. Of these sets, 731 (11.

Anaerobic bacteremia: the yield of positive anaerobic blood cultures: patient characteristics and potential risk factors.

The anaerobic blood culture (AN) bottle is routinely used in Japan with little discussion as to its justification or validity. We retrospectively studied the AN bottle yield of obligate anaerobes and the characteristics of, and potential risk factors in, patients with anaerobic bacteremia during a 2-year period (1999-2000) at four university hospitals and one community hospital. Thirty-four of 18,310 aerobic and anaerobic blood culture sets from 6,215 patients taken at the university hospitals, and 35 of 2,464 samples taken from 838 patients at the community hospital, yielded obligate anaerobes.

Biliary bacteria in living related liver transplant recipients: microbiology and rapid detection system using flow cytometry.

Since cholangitis is a major complication in living related liver transplant (LRLT) recipients, rapid detection of biliary bacteria is necessary for the management of patients. We have developed a screening method for the detection of biliary bacteria using flow cytometry (FCM). Two hundred and seventy eight bile samples were obtained from 50 patients with biliary drainage tubes after LRLT at Kyoto University Hospital between July and September 2001.

Evaluation of a commercially available serologic assay for antibodies against tuberculosis-associated glycolipid antigen.

A commercially available enzyme immunoassay developed to detect antibodies to a tuberculosis-associated glycolipid antigen was evaluated for serologic diagnosis of tuberculosis. This was a multicenter study comparing the assay with other methods in 78 patients with active pulmonary tuberculosis and in 54 controls with non-tuberculous lung diseases. Sensitivities were highest for sputum culture (91.