The needs of patients with noncancer diseases and their families from hospital-based specialized palliative care teams in Japan.

Background: Hospital-based specialized palliative care teams (HSPC) are important for symptom management and ethics support, especially during complex decision-making, but the needs of patients with noncancer diseases and their families from the HSPC are unclear. This study aimed to (I) compare the prevalence of symptom between patients with and without cancer and explore changes in symptom intensity after HSPC consultation in patients with noncancer; (II) determine factors related to ethics support; and (III) compare the percentage of request contents from patients and their families when a certified nurse specialist in gerontological nursing (geriatric care nurse below) is present in the HSPC to that when a certified nurse specialist in palliative care (palliative care nurse below) is present in the HSPC.

Methods: We utilized a retrospective cohort study to analyze 761 patients (360 with noncancer and 401 with cancer) referred to our HSPC at the National Center for Geriatrics and Gerontology using 10-year data (since 2011) available in an electronic medical record database.

Impact of Protein Intake after Intensive Care Unit on Discharge Destination for Critically Ill Patients: A Single-Center Prospective Observational Study.

Introduction: Although nutritional therapy may be able to enable intensive care unit (ICU) survivors to return home instead of being discharged to a rehabilitation facility, post-ICU discharge nutritional therapy lacks investigation. This study evaluated the impact of nutritional therapy after ICU on discharge destination in critically ill patients.

Methods: We enrolled consecutive adult patients who spent >72 h in the ICU from December 2020 to March 2023.

Transverse Colon Volvulus Secondary to the Persistent Descending Mesocolon: A Case Report.

This case report introduces a rare occurrence of transverse colon volvulus associated with persistent descending mesocolon (PDM), a congenital anomaly characterized by the medial positioning of the descending colon due to a failed fusion with the dorsal abdominal wall. We detail the case of an 18-year-old female, with a medical history of surgically corrected coarctation of the aorta and anal atresia, who presented with recurrent transverse colon volvulus despite having undergone a laparoscopic colopexy three years earlier. Physical examination revealed abdominal distension and metallic colic sounds while imaging studies confirmed the recurrence of the volvulus.

Risk Factors for Thrombocytopenia Induced by Capecitabine Plus Oxaliplatin Therapy in Patients With Colorectal Cancer.

Background/aim: Capecitabine plus oxaliplatin (CapeOX) therapy is used as an adjuvant chemotherapy regimen for patients with colorectal cancer (CRC). Although oxaliplatin induces thrombocytopenia, the risk factors for thrombocytopenia in oxaliplatin-treated patients with CRC are not well established. We aimed to investigate the risk factors for thrombocytopenia in CapeOX-treated patients with CRC.

The optimal glycemic target in critically ill patients: an updated network meta-analysis.

Acute glycemic control significantly affects the clinical outcomes of critically ill patients. This updated network meta-analysis examines the benefits and harms of four target blood glucose levels (< 110, 110-144, 144-180, and > 180 mg/dL). Analyzing data of 27,541 patients from 37 trials, the surface under the cumulative ranking curve for mortality and hypoglycemia was highest at a target blood glucose level of 144-180 mg/dL, while for infection and acute kidney injury at 110-144 mg/dL.

[A Case of Synchronous Bilateral Breast Cancer with Apocrine Feature].

The patient, a 79-year-old woman, noticed a lump in her left breast, prompting her visit to our hospital. A mass approximately 20 mm in size was palpated in the left A region. Mammography showed a spiculated mass in the left MIO region, while breast ultrasonography revealed an irregularly shaped hypoechoic mass in the left A region, as well as a hypoechoic area in the right C region.

Duplication of the appendix masquerading as appendiceal tumor: a case report.

Background: This case report highlights the exceptional rarity of appendix duplication in adults, a condition that closely mimics appendiceal tumors, posing diagnostic challenges. The novelty of this case lies in its presentation of a Type A duplication, emphasizing the diagnostic intricacies involved in distinguishing it from other pathologies.

Case Presentation: We present the case of a 69-year-old male with a history of hypertension, hyperuricemia, and duodenal gastric ulcer, who presented with a positive occult blood test.

Anaphylactic shock due to intra-articular injection of diclofenac etalhyaluronate sodium: A case report.

Background: Anaphylactic shock of diclofenac etalhyaluronate agent can be prolonged and recurrent. However, its reports are rare, and consequently, its method of management remains to be established.

Case Presentation: A 65-year-old woman received an intra-articular injection of diclofenac and hyaluronate.

The influence of steroid type on outcomes in patients with acute respiratory distress syndrome.

Background: Recent systematic reviews and meta-analyses have suggested that low-dose steroids are effective in the treatment of acute respiratory distress syndrome (ARDS). Recent guidelines recommend the use of low-dose steroids instead of high-dose steroids. These systematic reviews were conducted based on the concept that the effect of steroids is constant regardless of their type.

Persistent contrast-filling in the woven endobridge device three months after its implantation for cerebral aneurysm: Incidence, predictive factors, and outcome.

Objective: The Woven EndoBridge (WEB) was developed to treat wide-neck bifurcation intracranial aneurysms. Occasionally, persistent contrast-filling has been observed in the WEB after treatment. The purpose of our study was to investigate its incidence, predictive factors, and clinical impact.

Colostomy fistula caused by segmental absence of intestinal musculature: a case report.

Background: Segmental Absence of Intestinal Musculature (SAIM) is a rare condition associated with intestinal obstruction and perforation. Colostomy fistula as a presentation of SAIM and their association with anastomotic failure have not been previously reported. This case report aimed to raise awareness of this unique manifestation and its potential implications.

Relationship between tinnitus and olfactory dysfunction: audiovisual, olfactory, and medical examinations.

Introduction: Sensory dysfunctions and cognitive impairments are related to each other. Although a relationship between tinnitus and subjective olfactory dysfunction has been reported, there have been no reports investigating the relationship between tinnitus and olfactory test results.

Methods: To investigate the relationship between tinnitus and olfactory test results, we conducted sensory tests, including hearing and visual examinations.

Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study.

Foot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed.

Internal hernia in the medial inguinal fossa with a concurrent indirect inguinal hernia: a case report.

A 51-year-old male was presented with abdominal pain and vomiting. Contrast-enhanced computed tomography showed a dilated small intestine with a sac-like appearance in the right lower abdomen. An internal hernia in the inguinal area was found during emergency laparoscopic exploration.

Do heel-unloading orthoses improve clinical outcomes in patients after surgical treatment of calcaneal fracture? A propensity-matched, multicenter analysis of the TRON database.

Background: Postoperative protocols after surgical treatment of calcaneal fracture have not been standardized to date. There are only a few reports on the efficacy of heel-unloading orthoses (HUOs; Mars shoe, Graffin orthosis), and thier efficacy is uncertain.

Objectives: The purpose of this study was to compare postoperative radiologic and clinical outcomes in patients with calcaneal fractures who used Graffin orthosis.

Effect of multidisciplinary interventions in perioperative management center on duration of preoperative fasting: A single-center before-and-after study.

Objectives: Our aims were to clarify the actual situation regarding preoperative fasting and determine whether multidisciplinary interventions in a perioperative management center shorten the duration of preoperative fasting.

Methods: The cohort of this before-and-after study comprised patients undergoing elective surgery aged 18 years or older who underwent general anesthesia at one of three stages: after starting a short preoperative fasting protocol (Group A), after the anesthesiologist started explaining the protocol (Group B), and after the start of the perioperative management center (Group C). Instructions on drinking clear fluids were given up to 2 h and 4 h before the start of elective surgery to the first patient on the list (on-time) and to the second and subsequent patients (on-call), respectively.

Persistent brain damage in reversible cerebral vasoconstriction syndrome on Tc-ethyl cysteinate dimer single-photon emission computed tomography: A long-term observational study.

Background: Blood-brain barrier (BBB) breakdown is considered a key step in the pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS); however, its temporal course remains unclear. Based on the characteristics and dynamics of Tc-ethyl cysteinate dimer (Tc-ECD) as a tracer, Tc-ECD single-photon emission computed tomography (SPECT) can detect not only hypoperfusion but also BBB breakdown and/or brain tissue damage. Therefore, this study aimed to investigate this course using Tc-ECD SPECT.

A case of childhood unilateral relapsing primary angiitis of the central nervous system.

The patient was a 17-year-old girl with transient right-sided weakness and dysesthesia associated with headache and nausea. Head magnetic resonance imaging (MRI) revealed white matter lesions confined to the left hemisphere. Initially, multiple sclerosis was suspected, and methylprednisolone (mPSL) pulse therapy was administered, followed by fingolimod hydrochloride.

Acute progression of cerebral amyloid angiopathy-related inflammation diagnosed by biopsy in an elderly patient: A case report.

Background: Cerebral amyloid angiopathy-related inflammation (CAA-I) presents with slowly progressive nonspecific neurological symptoms, such as headache, cognitive function disorder, and seizures. Pathologically, the deposition of amyloid-β proteins at the cortical vascular wall is a characteristic and definitive finding. Differential diagnoses include infectious encephalitis, neurosarcoidosis, primary central nervous system lymphoma, and glioma.

Prediction of postoperative atrial fibrillation with the systemic immune-inflammation index in patients undergoing cardiac surgery using cardiopulmonary bypass: a retrospective, single-center study.

The systemic immune-inflammation index (SII, platelet count × neutrophil-lymphocyte ratio) is a novel parameter for systemic inflammation. Cardiopulmonary bypass (CPB) is associated with systemic inflammatory responses. This retrospective study aimed to determine whether SII could predict postoperative atrial fibrillation (POAF) after cardiac surgery using CPB.