The aim of this study is to clarify the outcomes of blood culture tests in patients with advanced cancer receiving hospice care. A total of 527 patients who took blood culture tests between April 2021 and March 2024 at our palliative care unit were included in the study. The rate of multiple blood culture set collection, positivity rate and contamination rate were 73.4%, 22.5% and 2.6%, respectively. The most-frequently-isolated pathogen was coagulase-negative staphylococci (28.8%). The rate for antimicrobial-resistant bacteria was 4.5%. Among the positive patients, 79.2% were administered appropriate antimicrobial regimens based on the drug susceptibility tests. The most frequently used antimicrobial as targeted therapy for bacteremia was vancomycin (31.5%). Despite their short lifespans, we conclude that blood culture test can be beneficial for patients receiving palliative care. Further observational studies are required to clarify characteristics of infectious diseases in terminally-ill patients with advanced cancer.

Objective: Osteoporotic vertebral fracture (OVF) is conventionally treated with conservative management such as bed rest, but a relatively prolonged bed rest has the potential risk of muscle disuse atrophy. This study aimed to examine whether the 2-week of rigorous bed rest affects muscle disuse atrophy in OVF patients.Patients and Methods: A total of 54 OVF patients (16 males; 38 females; mean age, 80.2 ± 9.2 years) were treated with an initial 2-week rigorous bed rest by hospitalization with persistent rehabilitation. Cognitive function, swallowing function, grip strength, and lower extremity circumference were evaluated at three-time points (admission, end of bed rest, and discharge).Results: Of the 51 patients who were able to walk independently before the injury, one patient (2.0%) had to use a wheelchair after the injury. During hospitalization, cognitive function decline was observed in 33.3% of patients, but not in patients with Revised Hasegawa’s Dementia Scale score ≥25 at admission. Swallowing function decline was observed in one patient, and none of the patients developed aspiration pneumonia during hospitalization. The grip strength significantly improved both at the end of bed rest (P=0.04) and discharge (P=0.02). Although the lower extremity circumference significantly decreased at the end of bed rest (P<0.01), it was recovered afterward. The lower extremity circumference did not significantly differ between the admission and discharge (P=0.17).Conclusion: Our results suggested that conservative treatment of OVF through an initial 2-week rigorous bed rest with persistent hospital rehabilitation poses a low risk of muscle disuse atrophy. If cognitive dysfunction is observed on admission, close monitoring for exacerbation should be performed during the hospital stay.

  【Introduction】One of the effects of the hot spring provides worm temperature. This effect raises temperature, and temperature control function operates and causes increase of the bloodstream. This time, these changes examined the thing by the size of the bathtub and the spring quality of the hot spring.   【Subjects and Methods】The subjects were 10 healthy adult men (mean age: 25.2 years). They bathed for 10 min in bathtubs at 42°C. The enforcement used plunge bath (approximately 1,700 L: simple alkaline hot spring) and home bathtub (approximately 300 L: hot water, 0.1% artificially chlorinated spring). Measurement item of the maximum arterial blood flow rate using the Ultrasonic Rheometer Smart Doppler 45, deep body temperature using the deep body temperature monitor core temperature CM-210, I compared each value 10 min during the bathing, and during a 10-min, 20-min, 30-min resting period after bathing, furthermore, I found the conjugation on each condition resting period after bathing.   【Result】The rise in deep body temperature and maximum arterial blood flow rate showed the result that a hot spring of the plunge bath was more meaningful than the value of the home bathtub after 10 min of bathing. The deep body temperature of the hot spring of the plunge bath significantly rose from bathing 3 min after. In deep body temperature with the resting period after bathing, in the hot spring of the plunge bath, a meaningful rise was maintained in hot water 13 min for population chloride spring 16 min of the home bathtub for 15 min.  【Discussion】In thinks that a population spring let you maintain a temperature rise that it disturbs a drop of the water temperature by abundant quantity of water in the plunge bath that hot spring plunge bath had a bigger deep body temperature rise, maximum arterial blood flow rate than home bathtub, and the deep body temperature rise in the home bathtub was continued.

Background: We investigated how individual home care services by nurses, care workers, and therapists at patients' homes are related with the continuation of home medical care service provided by medical doctors.Methods: This research retrospectively analyzed primary insured patients registered with the Japanese long-term care insurance system who had newly started using home medical care service, and whose care level was between 1 and 5 according to national long-term care insurance system claims data. We performed multivariable logistic regression analysis to evaluate patients who used home medical care continuously for >3 months and the utilization of each home care service adjusted for patient age, gender, and care level.Results: A total of 26,590 patients were analyzed. Multivariable analysis revealed that the following home care services were associated with longer continuation of home medical care service compared with home medical care alone: day service (OR, 2.10; 95% CI, 1.98-2.23), home help service (1.91; 1.81-2.01), day care including rehabilitation (1.88; 1.69-2.10), home-visit rehabilitation (1.49; 1.31-1.69), and home-visit nursing (1.23; 1.16-1.31).Conclusions: Our results demonstrated a correlation between utilization of home care services and longer continuation of home medical care from the start. These findings may help medical doctors who provide home medical care service collaborate with other home care services by nurses, care workers, and in-home care therapists.

  Komono Town is a well-known spa and health resort in Mie Prefecture. Komono Town has been seeking ways to promote the activities of hot spring area and health resources in surrounding areas. As part of these efforts, Komono Town has developed town-walk programs to promote the health of local residents. In this study, focusing on effect of walking on relaxation, we compared levels of stress hormones and emotional scores obtained before and after walking.  After giving their informed consent, adult participated in two walking programs, each for a distance of approximately 7 km. Salivary cortisol levels were measured before and after intervention. In addition, the Mood Check List-Short form. 2 (MCL-S.2) and a Visual Analog Scale (VAS) were used to rate emotions before and after intervention.  In both programs, walking tended to lower levels of salivary cortisol than resting. Low levels of cortisol, an adrenocortical hormone released during a state of predominantly sympathetic nervous activity, are thought to reflect mental relaxation; our result implies that the walking program enhanced relaxation in subjects. In addition, both MCL-S.2 and VAS rating showed that the subjects tended to feel better, more relaxed and less anxious after intervention.   These findings suggest that the walking programs are beneficial human body thorough, for example, enhanced relaxation.

  Komono Town is a well-known spa and health resort in Mie Prefecture. Komono Town has been seeking ways to promote the activities of hot spring area and health resources in surrounding areas. As part of these efforts, Komono Town has developed town-walk programs to promote the health of local residents. In this study, focusing on effect of walking on relaxation, we compared levels of stress hormones and emotional scores obtained before and after walking.

  After giving their informed consent, adult participated in two walking programs, each for a distance of approximately 7 km. Salivary cortisol levels were measured before and after intervention. In addition, the Mood Check List-Short form. 2 (MCL-S.2) and a Visual Analog Scale (VAS) were used to rate emotions before and after intervention.

  In both programs, walking tended to lower levels of salivary cortisol than resting. Low levels of cortisol, an adrenocortical hormone released during a state of predominantly sympathetic nervous activity, are thought to reflect mental relaxation; our result implies that the walking program enhanced relaxation in subjects. In addition, both MCL-S.2 and VAS rating showed that the subjects tended to feel better, more relaxed and less anxious after intervention.

  These findings suggest that the walking programs are beneficial human body thorough, for example, enhanced relaxation.

  Foot and hand baths are used well in partial baths. It is thought that a warm temperature effect varies according to the size of warmed part in a partial bath, but it is not clear. The purpose of this study is to examine the thermal response on the size of warming area and position during foot and hand baths. The subjects were ten young individuals (all men, average age 23.2 ± 1.3 years), and these individuals partook in a 15-min foot and hand bath. Subjects submerged themselves up to the lower thigh and forearm in a bath at 42°C, in a seated position, rested in the position for five min, and then rested for an additional five min after bathing. There are five styles for baths (single thigh, both thighs, single forearm, both forearms, and no bath). Tympanic temperature was taken with a thermistor, skin blood flow with a laser Doppler flowmeter, and sweat rate with capsule method on the right side. We measured whether the subjects felt warm and comfortable. Tympanic temperature was significantly increased in both the foot and hand baths. Skin blood flow and sweat rate showed no change under any condition. Warm temperature and subjects’ feelings of comfort varied for all bathing conditions, in comparison with no bath. Warm temperature feeling was significant for both the foot and hand baths, in comparison with single baths. The change in these temperatures depended on the surface area warmth in the bath, and the response of the warming at different parts of body was suggested by various factors.

  A foot bath is one of the partial baths which soaks a foot in hot water. The effect makes the blood circulation of the part of the warmed foot better, and is effective for fatigue, edema, poor circulation, and sleep. The purpose in this study is to examine how aging influences the change of the autonomic nerve during a foot bath. The subjects were nine elderly individuals (four men, five women, average age of 73.5 ± 8.4 years old), eight young individuals (all men, average age of 25.5 ± 3.4 years old), and for a 20-minute foot bath, when I touched the lower thigh to the 41°C bath in a seated position for rest ten minutes, performed rest after a foot bath for five minutes. Tympanic temperature with a thermistor, skin blood flow with a laser Doppler flowmeter, and blood pressure and heart rate with an automatic sphygmomanometer were measured. In the younger subjects, tympanic temperature was significantly increased compared to the elderly subjects, and skin blood flow was significantly increased during the foot bath in the lower thigh with both subjects, and the younger subjects were significantly increased compared to the elderly subjects. The femor-skin blood flow significantly increased only in the young subjects. The blood pressure did not change in the young subjects during the foot bath, but the elderly subjects’ pressure dropped. The heart rate increase was shown in the young subjects; however, it was not shown in the elderly subjects. It is thought that an increase of the quantity of fat and decrease of the muscle volume due to aging, a decline in the flexibility of the blood vessel, and attenuation of the sensitivity of the receptor affect the change of these autonomic nerve functions.

  In fall 2012, we renovated the grounds surrounding our hospital and constructed a “rehabilitation promenade,” along which patients could stroll and be in touch with the natural environment. The course is 500m long and includes pathways through a wood and along a pond. Using the promenade, patients can go for a stroll, exercise, or interact with other people. In our ambulatory rehabilitation center, the promenade has been incorporated in one of the center’s programs since last year. This time, we herein report a survey on the changes in the mental and physical function over a 6-month period from May 2013 and their satisfaction level with the use of the promenade by a questionnaire in December 2013.   22 subjects with a mean age of 77.5 ± 6.8 years were included in the survey on the mental and physical functions. Also, in satisfaction survey, valid responses were received from 58 individuals (mean age, 78.2 ± 8.2 years; 25 men and 33 women).   As a result, in terms of the 6-month changes in mental and physical functions were generally maintained.   In the questionnaire, more than 90% of users were satisfied with their use of the promenade, and the statistical analysis revealed that the highest level of satisfaction concerned going outside (p<0.01). For example, “I could feel the fresh air and the seasons” and “I could see a range of scenery.”   In addition, compare the results for each category according to sex, the women chose significantly more answers that were related to interacting with other people, whereas the men chose significantly more answers that were related to exercise.   From this survey, utilizing the surrounding environment may enable the development of more varied and satisfying forms of rehabilitation. We will continue with initiatives that utilize the promenade to help improve the QOL of those who use it.

Introduction: Prevention of the onset of cardio/cerebrovascular diseases, which represent circulatory system diseases, is now emphasized. It requires ensuring good arterial distensibility, which has been demonstrated to be reduced by life environments such as the lack of exercise or overnutrition but improved by aerobic exercise. Even if implementation of such exercises is possible, it increases the risks of the frail elderly with declined cardiopulmonary function and those with other diseases. This study aimed to focus on plantar flexion and dorsiflexion exercises of the ankles as a type of effective, low-load exercise that can induce dynamic stimulation associated with increased blood flow, using muscle pumping of the triceps surae and footbath, which could potentially increase overall blood flow via hyperthermic action. We then investigate the benefits of the combined effects of these two exercises on arterial distensibility. Methods: We selected 25 physically and mentally healthy adult men and women (17 men and eight women; mean ± SD age, 25.7 ± 3.3 years) as study subjects.   All the 25 subjects performed each of three exercises, namely footbath, ankle exercise, and ankle exercise in footbath, in a sitting position for 15 minutes. Ankle-brachial index (ABI), brachial-ankle pulse wave velocity (PWV), systolic blood pressure, diastolic blood pressure, and heart rate were measured using form PWV/ABI before and after the exercise for the evaluation of arterial distensibility. Results: No significant differences were observed in the PWVs, ABIs, systolic/diastolic blood pressures, and heart rates before and after exercise in the footbath and exercise groups. However, for the footbath exercise group, a significant reduction in PWV was observed from before to after exercise. Discussion: In this study, we focused our attention on the ankle exercise in footbath as a low-load exercise that could improve arterial distensibility. The results indicated a significant reduction in PWV, an index used to show the level of arterial distensibility, only for the footbath exercise group, which performed the combination of ankle exercise and footbath. We can infer that the improvement of arterial distensibility is attributed to the synergistic effect of the muscle pump and hyperthermic actions, which result in further increases and facilitation of cardiac output. Conclusions: This study demonstrated that the ankle exercise in footbath was beneficial for the improvement of arterial distensibility.