Esophageal perforation and epidural emphysema as complications of nasogastric tube placement.

We present a 72-year-old man with end-stage renal disease and Hashimoto encephalopathy in whom a diagnosis of epidural emphysema because of esophageal perforation by a nasogastric tube placement. Although its imaging findings may be alarming to clinicians, close monitoring and conservative treatment are advisable.

Annual report on National Clinical Database 2021 for gastroenterological surgery in Japan.

Aim: The Japanese National Clinical Database, which covers more than 95% of the surgeries performed in Japan, is the largest nationwide database. This is the 2021 annual report of the Gastroenterological Section of the National Clinical Database, which aims to present the short-term outcomes of cases registered in 2021 and discuss significant changes and insights into gastroenterological surgeries observed over the decade.

Methods: We reviewed the data of patients registered in the National Clinical Database between 2012 and 2021.

Integrating psychiatry into basic clinical skills: A three-year nationwide quantitative assessment of postgraduate training programs.

Aim: The aim of this study was to develop quantitative outcome indicators for psychiatric training programs integrated into the General Medicine In-Training Examination (GM-ITE) and to investigate which characteristics correlate with high scores in psychiatry.

Methods: A nationwide cross-sectional study was conducted over 3 fiscal years (2021-2023). An anonymous online questionnaire was distributed to postgraduate year 1 and 2 residents who completed the GM-ITE.

Saccular and Fusiform Abdominal Aortic Aneurysms Treated With Endovascular Repair Differ in Presentation and Treatment Threshold: Analyses Using a National Clinical Database in Japan.

Background: Saccular abdominal aortic aneurysms (AAAs) are considered to be at higher risk of rupture than fusiform AAAs, but not much is known about the extent of this risk. Therefore, this study aimed to compare the rupture presentation between fusiform and saccular AAAs.

Methods And Results: This is a retrospective cohort study on 27 290 patients who underwent primary endovascular repair for a degenerative AAA between 2016 and 2019, and who were registered in the National Clinical Database in Japan.

Residents' learning and behavior about tool-guided clinical assessment of social determinants of health.

Background: The specific dimensions of learners that have been impacted by educational programs related to social determinants of health (SDoH) remain unknown. This study aims to elucidate how learners are affected by postgraduate education (a single 90-min educational session) regarding tool-guided clinical assessment of patients' social backgrounds.

Methods: A pretest-posttest design was utilized in which residents (postgraduate year (PGY) 1 or 2) and fellows in family medicine (PGY over 3) were recruited.

The necessity of proactive measures from healthcare providers highlighted by delayed breast cancer diagnosis due to COVID-19: A case report.

Key Clinical Message: During disasters, multiple factors can cause significant delays in medical visits. Regular patient monitoring, high-risk individual alerts, and telemedicine enhancements can potentially alleviate these issues and ensure timely interventions.

Abstract: During the COVID-19 pandemic, a Japanese woman in her 70s delayed her regular breast cancer checkup for over 2 years.

Association between family caregivers' primary care experience when they report as patients and their stress related to caregiving: A pilot cross-sectional study.

Background: Few studies have examined whether family caregivers' own primary care providers can affect caregiving-specific well-being, such as caregiver stress. In this pilot study, we explored whether primary care experiences when family caregivers report as patients were associated with the stress of caregiving.

Methods: We used cross-sectional data from a survey conducted in Japan between November and December 2020.

Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan.

Aim: The National Clinical Database (NCD) of Japan is a nationwide data entry system for surgery, and it marked its 10th anniversary in 2020. The aim was to present the 2020 annual report of gastroenterological surgery of the NCD.

Methods: The data of the surgical procedures stipulated by the training curriculum for board-certified surgeons of the Japanese Society of Gastroenterological Surgery in the NCD from 2011 to 2020 were summarized.

Family caregivers' experience with healthcare and social care professionals and their participation in health checkups: A cross sectional study in Japan.

Background: For family caregivers, who are generally regarded as a vulnerable population, having regular checkups is a desirable health behavior. This study examined family caregivers' habit of having regular checkups prior to becoming involved with professionals who care for patients, and whether they had had recent checkups. We then examined the association between family caregivers' experience with professionals and their participation in checkups after adjusting for the past habit.

What kinds of work do Japanese primary care physicians who derive greater positive meaning from work engage in? A cross-sectional study.

Background: Despite the increasing need for primary care physicians (PCPs) around the world, few physicians choose it as a career. PCPs who can find meaning and enjoyment in their work can be role models for medical students and professionals, which may encourage more physicians to specialize in primary care. We aimed to compare the kinds of work that Japanese PCPs who derive greater positive meaning from work engage in versus those who derive less positive meaning from work.

Age-dependent treatment effect of vocal fold steroid injection for benign vocal fold lesions.

Objective: Benign vocal fold lesions (BVFLs) cause voice disorders and impair social life. Recently, office-based vocal fold steroid injection (VFSI) has gained attention as a minimally invasive treatment for BVFLs. This study aimed to analyze the age-dependent treatment effect of VFSI and to clarify the indications for treatment.

Reducing salt intake with umami: A secondary analysis of data in the UK National Diet and Nutrition Survey.

Reducing sodium content in foods is an important public health measure to reduce salt intake and decrease the incidence of noncommunicable diseases, such as cardiovascular disease and chronic kidney disease. This study quantified the amount of salt intake that could potentially be reduced by using umami substances, including glutamate, inosinate, and guanylate, without compromising taste, for adults in the United Kingdom (UK). We used data comprised of 1834 adults aged 20 years and over from the National Diet and Nutrition Survey (NDNS RP) 2016/2017-2018/2019.

Enzalutamide + androgen deprivation therapy (ADT) versus flutamide + ADT in Japanese men with castration-resistant prostate cancer: AFTERCAB study.

Objectives: The objective of the study is to compare the efficacy and safety of alternative androgen therapy (AAT) with enzalutamide + androgen deprivation therapy (ADT) and flutamide + ADT in the treatment of Japanese men with metastatic or nonmetastatic castration-resistant prostate cancer (CRPC) who progressed despite combined androgen blockade (CAB) with bicalutamide + ADT. AAT treatment sequence was also investigated.

Materials And Methods: The open-label, Phase 4 AFTERCAB study (NCT02918968) was conducted from November 2016 to March 2020 in Japanese men aged ≥20 years with asymptomatic or mildly symptomatic CRPC.

Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan.

Background And Aim: In Japan, the actual number of stoma constructions and stoma closures is not known. The aim of this study was to conduct a survey to determine the number of gastrointestinal stoma constructions and closures in Japan.

Methods: Enrolled participants comprised patients undergoing selected gastrointestinal surgeries who were recorded in the National Clinical Database.

Prediction of Lifetime Risk of Cardiovascular Disease Deaths Stratified by Sex in the Japanese Population.

Background Lifetime risk is an informative estimate for driving lifestyle and behavioral changes especially for young adults. The impact of composite risk factors for cardiovascular disease on lifetime risk stratified by sex has not been investigated in the Japanese population, which has a much lower mortality of coronary heart disease compared with the Western population. We aimed to estimate lifetime risk of death from cardiovascular disease attributable to traditional risk factors.

Surgical outcomes in gastroenterological surgery in Japan: Report of the National Clinical Database 2011-2019.

Background: We aimed to present the 2019 annual report of the gastroenterological section of the National Clinical Database (NCD).

Methods: We reviewed 609,589 cases recorded in 2019 and 5,029,764 cases registered from 2011 to 2019 for the 115 selected gastroenterological surgical procedures.

Results: The main features of gastroenterological surgery in Japan were similar to those described in the 2018 annual report, namely, that 1) operative numbers gradually increased in all procedures, except gastrectomy and hepatectomy, which decreased in these years; 2) in all eight major gastroenterological surgeries, the age distribution tended toward older patients; 3) the morbidity of esophagectomy, hepatectomy, and pancreaticoduodenectomy increased, but mortality was minimized in all procedures; 4) all eight major gastroenterological procedures have increasingly been performed under laparoscopy; and 5) board-certified surgeons were increasingly involved.

Primary care physicians' narratives on COVID-19 responses in Japan: Professional roles evoked under a pandemic.

Background: Within the vague system of primary care and COVID-19 infection control in Japan, we explored how primary care (PC) physicians exhibited adaptive performance in their institutions and communities to cope with the COVID-19 pandemic from January to May 2020.

Methods: Narrative analysis conducted by a team of medical professionals and anthropologists. We purposefully selected 10 PC physicians in community-based hospitals and clinics and conducted a total of 17 individual and group interviews.