Predictive Validity of Hospital-Associated Complications of Older People Identified Using Diagnosis Procedure Combination Data From an Acute Care Hospital in Japan: Observational Study.

Background: A composite outcome of hospital-associated complications of older people (HAC-OP; comprising functional decline, delirium, incontinence, falls, and pressure injuries) has been proposed as an outcome measure reflecting quality of acute hospital care. Estimating HAC-OP from routinely collected administrative data could facilitate the rapid and standardized evaluation of interventions in the clinical setting, thereby supporting the development, improvement, and wider implementation of effective interventions.

Objective: This study aimed to create a Diagnosis Procedure Combination (DPC) data version of the HAC-OP measure (HAC-OP-DPC) and demonstrate its predictive validity by assessing its associations with hospital length of stay (LOS) and discharge destination.

Indicative biomarkers of Lewy body disease as predictors of treatment resistance in late-onset depression.

Late-onset depression (LOD) may indicate the prodromal phase of Lewy body disease (LBD) and is often associated with treatment resistance. However, the relationship between treatment resistance and indicative biomarkers of LBD is still unknown. This retrospective study investigated whether I-ioflupane dopamine transporter single-photon emission computed tomography (DaT-SPECT) and I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy can predict treatment resistance in hospitalized patients with LOD.

[The expected role of Dementia Support Doctors in dealing with complex cases of older people with dementia].

Aim: The present studyinvestigated the roles expected of Dementia Support Doctors (DSDs) in dealing with complex cases.

Methods: The participants were attendees of the education programs organised by the Center for Promoting Dementia Support and the Medical Center for Dementia at the Tokyo Metropolitan Geriatric Hospital from April 2021 to March 2022. A self-administered postal questionnaire survey was conducted.

Association of functional and cognitive impairment severity with discharge to long-term care facilities in older patients admitted to a general acute care hospital from home.

Background: The early recognition of hospitalized patients at risk of being discharged to long-term care facilities (LTCFs) may help to identify those who require transitional care programs and interventions that support discharge to home. We examined the association of functional and cognitive impairment severity with discharge to LTCFs among older hospitalized patients.

Methods: In this retrospective cohort study, we used an administrative claims database linked with geriatric assessment data from a general acute care hospital in Japan.

Association of cognitive impairment severity with potentially avoidable readmissions: A retrospective cohort study of 8897 older patients.

Introduction: Understanding the association between cognitive impairment severity and potentially avoidable readmissions (PARs) in older patients may facilitate the identification of at-risk individuals who would benefit from readmission prevention measures.

Methods: This retrospective cohort study was conducted using claims data linked with routinely collected cognitive impairment assessment results from a general acute care hospital in Tokyo, Japan. Patients were 65 years or age or older who were discharged from the subject hospital to home or a facility between July 2016 and September 2018.

Characteristics of detected and undetected dementia among community-dwelling older people in Metropolitan Tokyo.

Aim: Although a series of policies have been adapted to deliver an early diagnosis of dementia, many people living with dementia remain undetected and undiagnosed. The aim of this study is to investigate the characteristics of undetected dementia in community-dwelling older people in Metropolitan Tokyo.

Methods: We conducted a three-step survey.

Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic.

Background: Although frailty and cognitive impairment are critical risk factors for disability and mortality in the general population of older inhabitants, the prevalence and incidence of these factors in individuals treated in the specialty outpatient clinics are unknown.

Methods: We recently established a frailty clinic for comprehensive assessments of conditions such as frailty, sarcopenia, and cognition, and planned 3-year prospective observational study to identify the risk factors for progression of these aging-related statuses. To date, we recruited 323 patients who revealed symptoms suggestive of frailty mainly from a specialty outpatient clinic of cardiology and diabetes.

Short- and long-term evaluation of cognitive functions after electroconvulsive therapy in a Japanese population.

Aim: While electroconvulsive therapy (ECT) is a well-established, safe, and effective treatment for mental illnesses, the potential for adverse effects on cognitive functions remains controversial. We aimed to evaluate multiple cognitive functions in different time periods before and after ECT in a Japanese population.

Methods: A battery of five neurocognitive tests was administered to patients who underwent a course of ECT treatment at three time points: before, immediately after, and 4 weeks after ECT.

[A clinical case of progressive supranuclear palsy with long-term frontal presentation preceding the onset of gaze palsy].

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder with diverse clinical phenotypes characterized by supranuclear gaze palsy, parkinsonism with postural instability, and frontal dementia. The early and accurate diagnosis of PSP remains difficult because of the variable combination of symptoms and frequent lack of gaze abnormalities early in the disease course. Moreover, a subset of PSP shows behavioral changes as the initial presentation, which considerably overlaps with the clinical picture of frontotemporal dementia (FTD).

A prospective naturalistic multicentre study of intravenous medications in behavioural emergencies: haloperidol versus flunitrazepam.

A prospective naturalistic multicentre study for deep sedation was conducted in intensive care with continuous electrocardiogram (ECG) monitoring. Clinical purpose was enough sedation, which made uncooperative and disrupted patients receive brain computed tomography (CT), magnetic resonance imaging (MRI), or fluid therapy, with minimum drug doses. A first infusion was either haloperidol (HAL group) or flunitrazepam (FNP group).

Olanzapine orally disintegrating tablet vs. risperidone oral solution in the treatment of acutely agitated psychotic patients.

Objective: Efficacy and tolerability of risperidone oral solution (RIS-OS) and olanzapine orally disintegrating tablet (OLZ-ODT) were compared for the treatment of acute psychotic agitation.

Method: During a 2-month period, patients scoring > or =15 on the Excited Component for Positive and Negative Syndrome Scale (PANSS-EC) were assigned to treatment with OLZ-ODT (n=34) or RIS-OS (n=53) on psychiatric emergency situations, and assessed every 15 min.

Results: Two (OLZ-ODT and RIS-OS) by five (0-, 15-, 30-, 45- and 60-min time points) repeated-measures analysis of variance revealed only a significant main effect of time course on PANSS-EC (F=82.

Perospirone in the treatment of patients with delirium.

Perospirone is a recently developed atypical antipsychotic with potent serotonin 5-HT2 and dopamine D2 antagonist activity. Other atypical antipsychotics including risperidone, quetiapine and olanzapine have been widely used for treatment, not only for schizophrenia symptoms but also for delirium, because of their low potential to induce extrapyramidal disturbances. In the present study the effectiveness and safety of perospirone in patients with delirium are described.

Average size of random polygons with fixed knot topology.

We have evaluated by numerical simulation the average size R(K) of random polygons of fixed knot topology K=,3(1),3(1) musical sharp 4(1), and we have confirmed the scaling law R(2)(K) approximately N(2nu(K)) for the number N of polygonal nodes in a wide range; N=100-2200. The best fit gives 2nu(K) approximately 1.11-1.

Antidiabetic effect of nitobegiku in KK-Ay diabetic mice.

In the past, nitobegiku (the herb of Tithonia diversifolia (Hemsl) A. Gray) has been used as a medicinal plant for diabetes. Antidiabetic effect of the water extract of Nitobegiku (NG) was investigated in KK-Ay-mice--one of the animal models of type 2 diabetes.