Introduction: This study examined the effectiveness of the modified Hospital Elder Life Program (HELP) for preventing delirium, which was adjusted to be used in acute internal medicine wards at general community hospitals in Japan.Methods: The pre-intervention group consisted of 751 patients aged 70 years or older hospitalized at Nishiyodo Hospital and Amagasaki Medical Co-op Hospital between January and July 2013. The post-intervention group consisted of 775 patients aged 70 years or older hospitalized between March and July 2017 and between October and December 2017. To address risk factors for delirium, a multicomponent intervention (modified HELP) consisting of the following was implemented: handing out pamphlets, orientation to maintain activity levels, sleep improvement, early initiation of rehabilitation, provision of glasses, hearing aids, and dentures, and the termination of continuous intravenous infusion. The Delirium Screening Tool was used to calculate the percentage of inpatients who developed delirium.Results: Of the 751 patients in the pre-intervention group, 108 (14.4%) developed delirium and 88 (11.4%) of the 775 patients in the post-intervention group exhibited delirium (odds ratio: 0.70; 95% confidence interval: 0.48-1.01; p=0.06).Conclusion: The modified HELP, adjusted for use in Japan, did not significantly reduce the rate of delirium during hospitalization. Therefore, a more universal intervention method is needed in the future.

Participants in our screening program for cerebrovascular disease are supposed to receive thyroid checkups at the time of ultrasound imaging of carotid arteries. Thus far, a total of 4,338 people have participated in this program. Of the total, 17 cases of papillary thyroid carcinoma were found (detection ratio: 0.39%). This study concerned with the 13 cases which underwent surgical treatment in our hospital. They all were diagnosed as early cancers--eight cases at stage N0 and five cases at stage N1--with an average tumor diameter of 11 mm. Besides, five cases of Basedow's disease (hyperthyroidism) and 15 cases of chronic thyroiditis were found (detection ratio: 0.35%). Of the 15 chronic thyroiditis cases, nine were found to have symptoms of hypothyroidism. We concluded that our screening program for cerebrovascular disease involving the ultrasonographic scans of the thyroid gland is very helpful not only in detecting malignancies at an early stage but also in screening for functional abnormalities of the thyroid.
Aspects of disease screening ; Ultrasonography ; Desiccated thyroid ; Thyroid Gland ; Diagnostic Neoplasm Staging