Bed rest for pregnant women recovering from threatened abortion and premature labor to prevent abortion can cause deconditioning syndrome, but it is not clear what kind of physical exercise should be provided for these patients. To better provide appropriate rehabilitation for threatened abortion and premature labor patients, we investigated patient clinical records retrospectively. In 11 patients who were provided rehabilitation within the past three years, eight delivered during hospitalization and three became independent in ADLs and were discharged while still pregnant. All patients who delivered during their hospitalization became independent in ADLs immediately after delivery, and as a result, the maternal prognosis was good. Choosing an appropriate rehabilitation approach for patients with threatened premature labor may help alleviate their deconditioning during pregnancy without any adverse impact.

STUDY DESIGN: A retrospective cohort study. PURPOSE: To investigate the risk factors for postoperative delirium after spine surgery, excluding older age, which has already been established as a strong risk factor. OVERVIEW OF LITERATURE: More than 30 risk factors have been reported for delirium after spine surgery, making it challenging to identify which factors should be prioritized. We hypothesized that risk factors could not be prioritized to date because the factor of older age is very strong and influenced other factors. To eliminate the influence of older age, we performed an age-matched group comparison analysis for the investigation of other risk factors. METHODS: This study involved 532 patients who underwent spine surgery. Two patients of the same age without delirium (delirium negative group) were matched to each patient with delirium (delirium positive group). Differences in suspected risk factors for post-operative delirium between the two groups identified from previous reports were analyzed using univariate analysis. Multivariate analysis was performed for factors that showed a significant difference between the two groups in the univariate analysis. RESULTS: Fifty-nine (11.1%) of 532 patients developed postoperative delirium after spine surgery. Large amounts of intraoperative bleeding, low preoperative concentration of serum Na, high postoperative (day after surgery) serum level of C-reactive protein, low hematocrit level, low concentration of albumin, and high body temperature were detected as significant risk factors in the univariate analysis. Large amounts of intraoperative bleeding remained a risk factor for postoperative delirium in the multivariate analysis. CONCLUSIONS: We should pay attention to and take precautions against the occurrence of postoperative delirium after spine surgery in patients of older age or those who experience severe intraoperative bleeding.
Body Temperature ; C-Reactive Protein ; Cohort Studies ; Delirium ; Hematocrit ; Hemorrhage ; Humans ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Spine

Surrogate decision-making support in the critical care field is a highly challenging form of support owing to its urgency and the fact that families are in crisis situations. Given this context, the diversification of families as a feature of modern society is thought to bring further difficulties to nurses who are involved in surrogate decision-making support. Therefore, this study sought to clarify the content of such support for diverse families that skilled nurses provided in the critical care field. We conducted semi-structured interviews with nine skilled nurses and a qualitative and inductive analysis of the obtained data. We extracted the following five categories of surrogate decision-making support. Even when there was no spare time in the critical care field, skilled nurses operated on the premise that family relationships and values are diverse while (1) “creating a foundation for surrogate decision-making that satisfied families” and (2) “making decisions based on a broad view of family relationships without being bound by preconceptions”, and they realized individualized support by (3) “adjusting the role of surrogate decision-makers based on family characteristics”. In cases where responses were difficult, it became clear that support was provided while (4) “responding to families in accordance with social norms” and demonstrating the ability to (5) “involve medical teams and finds solutions in difficult cases”.[[Please check that this conveys your intended meaning]]

We administered electro-acupuncture with the purpose of preventing repeated attacks of repetitive tonsillities.
The majority of the 77 subjects were kindergarden and elementary shool children, who had high fiver more then 4 times a year.
The treatment method was as follows: 1Hz low frequency stimulation between Co 4 and lu 6 (and this bilateral) for 20 to 30 minutes.
The treatment interval was once a week, with 3 weeks constituting a treatment course.
And depending on the results of 1 course, the treatment was repeated or not. 53 patients followed 1 course, 24 patients followed 2 course.
The evaluaton of the results is based on a 1 year observation period.
RESULTS:
-9 patients (11.68%) didn't got any high fever.
-49 patients (63.63%) noticed a decrease of the high fever frequency [39 patients (50.64%) got less then 3 times a year a high fever.]
-19 patients (24.67%) didn't notice any effect [6 patients (7.79%) got tonsillectomy.]
This study showed the usefulness of acupuncture and as it's a general and easy to apply therapy, we can consider acupuncture as a first choice therapy for the prevention off repetitive tosillitis.

BACKGROUND: In view of the increasing prevalence of food allergies, there has been an associated increase in frequency of situations requiring an emergency response for anaphylaxis at the home, childcare facilities and educational institutions. OBJECTIVE: To clarify the situation of adrenaline auto-injector administration in nursery/kindergarten/school, we carried out a questionnaire survey on pediatric physicians in Western Japan. METHODS: In 2015, self-reported questionnaires were mailed to 421 physicians who are members of the West Japan Research Society Pediatric Clinical Allergy and Shikoku Research Society Pediatric Clinical Allergy. RESULTS: The response rate was 44% (185 physicians) where 160 physicians had a prescription registration for the adrenaline auto-injector. In the past year, 1,330 patients were prescribed the adrenaline auto-injector where 83 patients (6% of the prescribed patients) actually administered the adrenaline auto-injector, of which 14 patients (17% of the administered patients) self-administered the adrenaline auto-injector. “Guardians” at the nursery/kindergarten and elementary school were found to have administered the adrenaline auto-injector the most. Among 117 adrenaline auto-injector prescription-registered physicians, 79% had experienced nonadministration of adrenaline auto-injector at nursery/kindergarten/school when anaphylaxis has occurred. The most frequent reason cited for not administering the adrenaline auto-injector was “hesitation about the timing of administration.” CONCLUSION: If the adrenaline auto-injector was administered after the guardian arrived at the nursery/kindergarten/school, it may lead to delayed treatment of anaphylaxis in which symptoms develop in minutes. Education and cooperation among physicians and nursery/kindergarten/school staff will reduce the number of children suffering unfortunate outcomes due to anaphylaxis.
Anaphylaxis ; Child ; Education ; Emergencies ; Epinephrine ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Japan ; Nurseries ; Postal Service ; Prescriptions ; Prevalence

The aim of this study was to clarify the nature of psychological conflict among men aged 80 years or older who were living alone in eight depopulated municipalities designated by Japan's Ministry of Internal Affairs and Communications. Semi-structured interviews were conducted with 34 elderly men who were living alone. Text-mining analysis revealed that elderly men living alone in depopulated villages were feeling lonely because they [did not have anyone to talk to] but did not want to leave their homes. They were aware of [progressive decline in physical functions] after the age of 80 and thought that [it would be the end if no longer being able to walk]. Because they needed to drive a car in order to continue living their lives, they were [conflicted about continuing to drive] and [anxious that they would not be able to go shopping] if they were to stop driving. The elderly men living in depopulated villages had developed human relationships and attachments to their hometowns, and they wanted to continue living in the homes they were born and raised in until the end of their lives. At the same time, they were struggling with conflicts related to loneliness caused by the weakening of human relationships, feelings of self-deficiency due to physical decline, and a sense of crisis stemming from the decline of the community. On the other hand, one factor supporting them was their motivation to protect the community. These findings suggest the need for a community care system that helps older people feel a sense of solidarity with, and a sense of contribution to, the community.

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.
Asian Continental Ancestry Group ; Colectomy ; Colitis, Ulcerative ; Colorectal Neoplasms ; Consensus ; Crohn Disease ; Disease Management* ; Disease Progression ; Early Intervention (Education) ; Epidemiology ; Expert Testimony ; Gastrointestinal Tract ; Hospitalization ; Humans ; Inflammatory Bowel Diseases* ; Japan* ; Prevalence ; Prognosis