Regional Collaboration for Heart Failure Patients Certified as Needing Support or Care in Long-Term Care Insurance System.

Background: Heart failure (HF) patients with complex care needs often experience exacerbations during the transitional phase as care providers and settings change. Regional collaboration aims to ensure continuity of care; however, its impact on vulnerable patients certified as needing support or care under the Japanese long-term care insurance (LTCI) system remains unclear.

Methods And Results: We implemented a regional collaborative program for HF patients involving 3 pillars of transitional care with general practitioners and nursing care facilities: (1) standardized health monitoring using a patient diary and identification of exacerbation warning signs; (2) standardized information sharing among care providers; and (3) standardized HF management manuals.

Association of a Transitional Heart Failure Management Program With Readmission and End-of-Life Care in Rural Japan.

Evidence on transitional care for heart failure (HF) in Japan is limited. We implemented a transitional HF management program in rural Japan in 2019. This involved collaboration with general practitioners or nursing care facilities and included symptom monitoring by medical/nursing staff using a handbook; standardized discharge care planning and information sharing on self-care and advance care planning using a collaborative sheet; and sharing expertise on HF management via manuals.

Factors affecting the willingness of nursing care staffs for cooperation with heart failure care and the role of internet video education.

Background: With the aging of heart failure (HF) patients, collaboration between medical and nursing care facilities is essential for HF care. The aims of this study were: (1) to identify the factors that affect willingness of nursing care staffs to cooperate with HF care; (2) to test whether the internet video education is useful in improving their willingness to collaborate.

Methods: A web-based questionnaire was e-mailed to 417 registered medical corporations that operated nursing care facilities in the prefecture where the authors work.

Differences in needs for community collaboration for heart failure between medical and nursing care staff.

The increased numbers of older and frail patients with heart failure (HF) means there is an urgent need to establish regional collaborative systems for medical and nursing care. However, expectations related to collaborative HF care among medical and care staff remain unclear. We conducted a questionnaire survey with staff in hospitals, clinics, and nursing care facilities (NCFs) who had experienced collaboration through the common HF collaborative pathway in the western region of Tottori Prefecture, Japan, from July 2019 to July 2020.

Case report: Osteomalacia due to bisphosphonate treatment in a patient on hemodialysis.

Background: No publications have reported on osteomalacia in patients receiving intermittent cyclical therapy with etidronate (a bisphosphonate) and undergoing long-term hemodialysis (HD).

Case Presentation: We report on a 46-year-old Japanese man admitted to our hospital for further examination of left forearm pain. Maintenance HD was started at age 24 years, and the man had been on HD since then.

New bone-like tissue formation in calcific tendinopathy: A case report.

Currently, the pathogenesis of nontraumatic heterotopic ossification (HO), e.g., bone-like tissue in calcific tendinopathy remains unclear.

Diaphyseal femoral fracture due to severe vitamin D deficiency and low parathyroid hormone levels on long-term hemodialysis: a case report.

Introduction: Currently, there are no reports of diaphyseal femoral fracture equivalent to atypical femoral fractures (AFFs) in patients receiving long-term hemodialysis (HD).

Case Report: A 56-year-old Japanese man receiving long-term HD for 34 years was admitted to our hospital due to a delay in postoperative healing. The patient began maintenance hemodialysis at 22 years of age.

Evaluation of the effectiveness of the sliding sheet in repositioning care in terms of working time and subjective fatigue: A comparative study with an experimental design.

Background: Manual patient handling is a major cause of low back pain among healthcare staff. The sliding sheet is an assistive device designed to aid healthcare staff performing patient repositioning in bed. The use of sliding sheets in healthcare facilities is currently relatively rare because of the perceived additional time required compared with non-assisted handling.

A case of uterine lymphangioleiomyomatosis in a young woman that was identified via peritonitis.

Although lymphangioleiomyomatosis is often observed with tuberous sclerosis, uterine lymphangioleiomyomatosis is rare. Our patient was 36 years old (gravida 0, para 0). She had a history of tuberous sclerosis, and many myometrial cystic lesions were identified during assisted reproductive therapy.

Destructive Spondyloarthropathy in Patients on Long-Term Peritoneal Dialysis or Hemodialysis.

Destructive spondyloarthropathy (DSA) is the most serious spinal complication of dialysis-related amyloidosis in patients on long-term hemodialysis (HD), but we could not find any information about DSA in patients on peritoneal dialysis (PD) for over 10 years. We retrospectively evaluated factors contributing to DSA in HD and PD patients. Sixty-seven patients on dialysis for 10 to 19 years were compared between a PD group (n = 23) or a HD group (n = 44).

Spontaneous spinal epidural hematoma during pregnancy: three case reports.

We present three extremely rare cases of spontaneous spinal epidural hematoma occurring in pregnancy. The patients developed progressive paralysis of the upper and lower limbs and the diagnoses were confirmed by magnetic resonance imaging. Urgent decompression is required to prevent neurological sequelae.

Two cases of ectopic ovary and one case of potential ectopic ovary.

Ectopic ovary is a rare gynecologic entity. A variety of synonymous terms such as ectopic ovary, supernumerary ovary, accessory ovary, and autoamputation of the ovary have been used to describe this condition. The etiology for ectopic ovary has not been elucidated, but several mechanisms have been proposed.

Bilateral interruption of mid-fallopian tubes and ovarian anomalies including ectopic ovary and cystic teratoma, a previously unreported combination.

A 25-year-old infertile woman underwent laparoscopy because of a dermoid cyst of the left ovary and was found to have an ectopic ovary, to which an abnormal right fimbria was connected, with an isolated right ovary in the normal position and the bilateral segmental absence of the middle portion of the fallopian tubes. The complex of these anomalies is rare. A fundamental error might have existed in the mesenchyme of the gonadal ridges of the early embryo, rather than the epithelial origin of the müllerian and wolffian ducts.

Clinical features and characteristics of blood flow of uterine vascular abnormalities.

Purpose: The purpose of this study was to assess the clinical features and characteristics of the blood flow in uterine vascular abnormalities using ultrasound and magnetic resonance imaging (MRI).

Methods: A total of 17 women were diagnosed with uterine vascular abnormalities by ultrasound. The clinical characteristics of the patients and the distribution and waveform of the intrauterine vessels were examined using transvaginal gray-scale and Doppler ultrasonography, spin-echo MRI, and MR angiography.

Stabilizing effects of eicosapentaenoic acid on Kv1.5 channel protein expressed in mammalian cells.

We investigated the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on the stability of Kv1.5 channel protein. The expression and function of Kv1.

Functional stabilization of Kv1.5 protein by Hsp70 in mammalian cell lines.

The aim of this study was to elucidate the mechanisms for regulations of cardiac Kv1.5 channel expression. We particularly focused on the role of heat shock proteins (Hsps).

Efficacy of selective venous catheterization in localizing a small androgen-producing tumor in ovary.

Background: Androgen-producing tumors, originating mostly in the ovary or adrenal gland, induce hirsutism. It sometimes is difficult to localize the tumor precisely even with modern imaging technology. We used selective venous catheterization and hormonal sampling (SVCHS) to localize an androgen-producing ovarian tumor.

Inhibition of beta-adrenergic signaling by intracellular AMP is independent of cell-surface adenosine receptors in rat cardiac cells.

We report a novel action of intracellular adenosine monophosphate (AMP) to inhibit beta-adrenergic signaling in isolated rat ventricular myocytes. Extracellular application of adenosine or AMP suppressed isoproterenol (Iso)-induced prolongation of action potential duration (APD). This effect was completely abolished by an A(1)-receptor antagonist, DPCPX.

Usefulness of arterial blood gas analysis and D-dimer measurement in the assessment of pulmonary embolism after orthopedic surgery.

Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) after spinal or lower extremity surgery are well recognized as common complications. Since 1995 we have investigated the incidence of PE after orthopedic surgery using ventilation-perfusion (V/Q) lung scans, and the prevalence of PE was about 10%. With a view to detecting early-stage PE by simple examinations, we evaluated the use of both the blood gas analysis and the D-dimer measurement after spinal or lower extremity surgery.

Postoperative adhesion formation after laparoscopic uterine horn resection in a porcine model: comparison of five instruments.

Purpose: To evaluate the postoperative adhesion formation caused by instruments used in gynecologic laparoscopic surgery and to determine the optimal instruments to use to reduce adhesions.

Materials And Methods: Seventeen juvenile pigs underwent laparoscopic bilateral resection of the uterine horns under general anesthesia and pneumoperitoneum. The laparoscopic procedures were carried out using monopolar electrocautery (ME) (n = 8), an electrothermal bipolar vessel sealer (EBVS) (n = 6), an ultrasonically activated scalpel (UAS) (n = 6), a loop-type ligature (LTL) with a steel scalpel for severing the tissues (n = 6), and an automatic stapling device (ASD) (n = 8).