A fracture liaison service (FLS) is a secondary fracture prevention program that is led by a coordinator. A program called the osteoporosis liaison service (OLS), which includes FLS, was first implemented in Japan and has become popular for solving problems related to osteoporosis treatment. OLS and FLS have the same purpose, namely preventing fragility fractures, but while FLS focuses mainly on secondary fracture prevention in fracture patients, OLS addresses this issue as well as primary fracture prevention at clinics and in communities.
Humans ; Japan ; Osteoporosis

"Locomotive syndrome" is used to designate the condition of individuals with musculoskeletal disease who are highly likely to require nursing care. This article reviews screening, prevalence, causal and related factors, and the relationship between locomotive syndrome and falls and fractures in older adults with this syndrome. A few self-administered questionnaire tools are available to assess individuals for locomotive syndrome. Additionally, screening methods, including a physical functioning assessment, are appropriate for detailed discrimination of locomotive syndrome. The prevalence of locomotive syndrome is significantly higher in women than in men, and tends to increase markedly from 70 years of age. More severe locomotive syndrome is related to knee pain, osteoporosis, sarcopenia, and lumbar disease. The incidence of falling in locomotive syndrome is higher than the incidence for the older population in general. Locomotive training including squats and a unipedal standing exercise has been recommending to prevent locomotive syndrome. This training improves muscle strength and balance function for older people who have a risk for locomotive syndrome.
Accidental Falls* ; Adult ; Aged* ; Asian Continental Ancestry Group* ; Discrimination (Psychology) ; Female ; Humans ; Incidence ; Knee ; Male ; Mass Screening ; Muscle Strength ; Musculoskeletal Diseases ; Nursing Care ; Osteoporosis ; Prevalence ; Sarcopenia

Since arteriosclerosis is a general progressive disease, an aneurysm of the thoracic aorta is not infrequently complicated by ischemic heart disease. Therefore, assessment of indications of surgical treatment and selection of the surgical procedure and auxiliary procedures on the basis of accurate preoperative evaluation of ischemic heart disease are considered to be very important for improving the results of operations for thoracic aortic aneurysm. Recently. we successfully operated on a 64-year-old patient with a left ventricular aneurysm and a descending aortic aneurysm. One-stage operation was performed by a left thoracotomy approach and partial left heart bypass by draining the pulmonary artery into the femoral artery with mild hypothermia. The approach and the auxiliary procedures employed in this patient are considered to be a useful combination applicable also to one-stage operation for descending aortic aneurysm and coronary artery bypass grafting.

A 2-month-old girl had been urgently seen on postnatal day 10 due to poor weight gain and tachypnea. Echocardiography showed congenital valvular aortic stenosis (AS), ventricular septal defect (VSD), atrial septal defect (ASD), and aortic valve dysplasia, but no cyst image was seen at the aortic valve level. Aortography revealed a dysplastic aortic valve along with coarctation of aorta (CoA) and patent ductus arterious (PDA). Balloon aortic valvotomy (BAV) was performed on day 53. Ballooning was satisfactory, but there was no change in gradient. Operation was performed on day 70 under a diagnosis of congenital AS and CoA complex. After cardiopulmonary bypass was established, the ascending aorta was transected. The blood cyst originated from the center of the anterior leaflet and was resected. The pressure gradient at the aortic valve decreased to 22.5mmHg. The patient was discharged 25 days after surgery.

OBJECTIVES: The purpose of this study is to clarify the psychological factors related to sarcopenia in patients with lumbar spinal stenosis (LSS). METHODS: This cross-sectional study included 72 patients with LSS (38 males and 34 females; mean age, 70.4 ± 6.9 years). Demographic data, lower extremity pain, back pain, Japanese Orthopaedic Association score, Pain Catastrophizing Scale (PCS) score, Hospital Anxiety and Depression Scale (HADS) score, Fear-Avoidance Beliefs Questionnaire score, walking velocity, grip strength, walking distance, and appendicular muscle mass were assessed. Muscle mass was measured using bioelectrical impedance analysis. Patients were grouped based on sarcopenia status according to skeletal muscle mass index. RESULTS: The prevalence of sarcopenia was 13.9% (10 of 72 patients). Sarcopenia was significantly more common in females. The incidence of dyslipidemia and cardiovascular disease were significantly higher in the sarcopenia group. The sarcopenia group had lower body weight, body mass index, grip strength, and walking distance than the control group. The sarcopenia group had higher PCS scores and HADS-anxiety scores. Multivariate analysis identified body weight, dyslipidemia, walking distance, and PCS score as significantly related to sarcopenia. CONCLUSIONS Pain catastrophizing might be the most relevant psychological factor in sarcopenia. Evaluation of both physical function and pain catastrophizing is needed when investigating sarcopenia in LSS.

No abstract available.

There have so far been no studies examining the physical fitness and physical activity (PA), measured using objective measures, in homebound elderly people. The purpose of this study was to examine physical fitness levels and PA patterns and evaluate their relationships in homebound elderly people. In 2004, a total of 3964 community-dwelling elderly aged 65 years and over participated in a base line survey. The subject data were directly collected by in-home interviewer. Subjects were defined as being homebound if they went outdoors less than once a week. However, the subjects who could not go out without assistance due to sickness and/or disability were excluded from the analysis. In 2005, 38 homebound (22 men, 16 women) and 70 non-homebound (33 men, 37 women) older adults who participated in the base line survey were selected. Measurements of physical fitness levels and PA patterns measured using an accelerometer, were taken in 2005. The total steps per day did not significantly differ between homebound and non-homebound men and women. The time spent in 1.8 METs activity (corresponding to activity level 1 of the accelerometer) was significantly higher in women than in men for non-homebound and homebound, respectively. The time spent in lower-, moderate-, and high-intensity PA did not significantly differ between homebound and non-homebound men and women, respectively. Handgrip strength, knee extensor strength, leg extensor power, stepping and maximum walking speed were significantly higher in non-homebound than in homebound men and women. These results suggest that the physical fitness levels of homebound were lower than those of non-homebound, but no difference was observed in the PA levels between homebound and non-homebound.

The work style of doctors gets attention within the Work Style Reforms that have been fully implemented since 2019. Now, we conducted a questionnaire survey at 10 institutions in Chugoku and Shikoku region and reviewed the latest work style of cardiovascular surgeons in comparison with other departments.

Purpose: The study aimed to compare the diagnostic performance of washout-parametric imaging (WOPI) with that of conventional contrast-enhanced ultrasound (cCEUS) in differentiating focal liver lesions (FLLs). Methods: A total of 181 FLLs were imaged with contrast-enhanced ultrasound using Sonazoid, and the recordings were captured for 10 minutes in a prospective setting. WOPI was constructed from three images, depicting the arterial phase (peak enhancement), the early portal venous phase (1-minute post-injection), and the vasculo-Kupffer phase (5 or 10 minutes post-injection). The intensity variations in these images were color-coded and superimposed to produce a single image representing the washout timing across the lesions. From the 181 FLLs, 30 hepatocellular carcinomas (HCCs), 30 non-HCC malignancies, and 30 benign lesions were randomly selected for an observer study. Both techniques (cCEUS and WOPI) were evaluated by four off-site readers. They classified each lesion as benign or malignant using a continuous rating scale, with the endpoints representing "definitely benign" and "definitely malignant." The diagnostic performance of cCEUS and WOPI was compared using the area under the receiver operating characteristic curve (AUC) with the DeLong test. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Results: The difference in average AUC values between WOPI and cCEUS was 0.0062 (95% confidence interval, -0.0161 to 0.0285), indicating no significant difference between techniques. The interobserver agreement was higher for WOPI (ICC, 0.77) than cCEUS (ICC, 0.67). Conclusion The diagnostic performance of WOPI is comparable to that of cCEUS in differentiating FLLs, with superior interobserver agreement.

Purpose: The study aimed to compare the diagnostic performance of washout-parametric imaging (WOPI) with that of conventional contrast-enhanced ultrasound (cCEUS) in differentiating focal liver lesions (FLLs). Methods: A total of 181 FLLs were imaged with contrast-enhanced ultrasound using Sonazoid, and the recordings were captured for 10 minutes in a prospective setting. WOPI was constructed from three images, depicting the arterial phase (peak enhancement), the early portal venous phase (1-minute post-injection), and the vasculo-Kupffer phase (5 or 10 minutes post-injection). The intensity variations in these images were color-coded and superimposed to produce a single image representing the washout timing across the lesions. From the 181 FLLs, 30 hepatocellular carcinomas (HCCs), 30 non-HCC malignancies, and 30 benign lesions were randomly selected for an observer study. Both techniques (cCEUS and WOPI) were evaluated by four off-site readers. They classified each lesion as benign or malignant using a continuous rating scale, with the endpoints representing "definitely benign" and "definitely malignant." The diagnostic performance of cCEUS and WOPI was compared using the area under the receiver operating characteristic curve (AUC) with the DeLong test. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Results: The difference in average AUC values between WOPI and cCEUS was 0.0062 (95% confidence interval, -0.0161 to 0.0285), indicating no significant difference between techniques. The interobserver agreement was higher for WOPI (ICC, 0.77) than cCEUS (ICC, 0.67). Conclusion The diagnostic performance of WOPI is comparable to that of cCEUS in differentiating FLLs, with superior interobserver agreement.