Purpose: The purpose of this study was to determine the relationship between the flexibility of the quadriceps femoris and the period from onset of the Osgood-Schlatter disease. Subjects: 45 patients (66 lower limbs) with Osgood-Schlatter disease participated in this study. Methods: Subjects were classified into acute-phase group (pain occurred within one month, 23 subjects, 32 lower limbs) and chronic-phase group (pain occurred over one month, 22 subjects, 34 lower limbs). As a measure of muscle flexibility of the quadriceps femoris, Heel-Buttock distance (HBD) were measured in all participants. Results: The flexibility of the quadriceps femoris within the chronic-phase group was significantly reduced flexibility (10.2 ± 6.5 cm) than in acute-phase group (4.6 ± 5.9 cm; p < 0.001). Conclusion: Patients of the OSD, even if not found a decrease in muscle flexibility of the quadriceps femoris during the acute phase, may be decrease the flexibility as time passes. Prevent the worse symptoms of OSD, it would be effective to introduce stretching from acute phase irrespective reduced flexibility in the physical therapy treatment plan.

A traumatic iliacus hematoma is rare and usually occurs in patients after a fall involving a lower back injury. Although the hematoma may compress the femoral nerve causing femoral nerve palsy, the gold standard treatment for this condition has not been established. Here we report transcatheter arterial embolisation as a useful treatment strategy for a traumatic iliacus hematoma.

Objective: Pharmacotherapy including mood stabilizers and antipsychotics are frequently used in bipolar disorder (BD); however, the lack of consensus regarding the definition of polypharmacy hinders conducting comparative studies across different settings and countries. Research on Asian Prescription Pattern (REAP) is the largest and the longest lasting international collaborative research in psychiatry in Asia. The objective of REAP BD was to investigate the prescription patterns of psychotropic medications across Asian countries. The rates of polypharmacy and psychotropic drug load were also analyzed. Methods: The data collection was web-based. Prescription patterns were categorized as (1) mood stabilizer monotherapy: one mood stabilizer; (2) antipsychotic monotherapy: one antipsychotic; (3) simple polypharmacy: one mood stabilizer and one antipsychotic; and (4) complex polypharmacy: ≥ 2 mood stabilizers or/and antipsychotics. The psychotropic drug load in each patient was calculated using the defined daily dose method. Results: Among 2003 patients with BD (52.1% female, 42.4 years) from 12 countries, 1,619 (80.8%) patients received mood stabilizers, 1,644 (82.14%) received antipsychotics, and 424 (21.2%) received antidepressants, with 14.7% mood stabilizer monotherapy, 13.4% antipsychotic monotherapy, 48.9% simple polypharmacy, 20.3% complex polypharmacy, and 2.6% other therapy. The average psychotropic drug load was 2.05 ± 1.40. Results varied widely between countries. Conclusion Over 70% of psychotropic regimens involved polypharmacy, which accords with the high prevalence of polypharmacy in BD under a permissive criterion (2 or more core psychotropic drugs) worldwide. Notably, ≥ 80% of our sample received antipsychotics, which may indicate an increasing trend in antipsychotic use for BD treatment.

Purpose: This study aimed to analyze the terminal care attitudes of healthcare members engaged in palliative care and the factors associated with these attitudes. Methods: We conducted a survey for healthcare members engaging in palliative care including oncologists and palliative care doctors using the Japanese version of the Frommelt Attitudes Toward Care of the Dying (FATCOD B-J), a scale that measures the attitude of medical stuff toward the care of dying patients. Results: A total of 223 (response rate=42.2%) responses were obtained and analyzed. Multiple regression analysis using the FATCOD B-J total score as the objective variable showed that 30s had lower partial regression coefficients than 40s (−3.8). Higher “satisfaction from work” and “interest in palliative care” were associated with greater partial regression coefficients (+5.7, +6.2). Conclusion: A sense of satisfaction and interest in palliative care may be important to cultivate terminal care attitudes among health care providers involved in palliative care.

Schistosomiasis japonica is one of seven NTDs endemic in the Philippines that continues to threaten public health in the country. The causative agent, the blood fluke Schistosoma japonicum, uses an amphibious snail Oncomelania hupensis quadrasi which can harbor larval stages that multiply asexually, eventually producing the infective cercariae which are shed into the water. Contamination of freshwater bodies inhabited by the snail intermediate host occurs through release of human and animal feces containing S. japonicum eggs. Miracidia hatching from these eggs subsequently infect the snails that inhabit these water bodies. The degree of fecal contamination can vary across snail sites and influences snail infection rates in these sites. In this study, conventional malacological surveys using intensive manual search for snails were conducted from 2015 to 2016 in seven selected endemic provinces, namely Leyte and Bohol in the Visayas and Surigao del Norte, Agusan del Sur, Bukidnon, Lanao del Norte and Compostela Valley in Mindanao. A total of 6,279 O. hupensis quadrasi snails were collected from 38 snail sites. The municipality of Trento in Agusan del Sur recorded the highest number of snail sites (7) that yielded O. hupensis quadrasi snails while only one snail site was found positive for O. hupensis quadrasi snails in Kapatagan in Lanao del Norte and Talibon in Bohol. Alegria in Surigao del Norte yielded the highest number of snail sites (5) that were found to harbor snails positive for S. japonicum infection. The snail infection rates in this municipality ranged from 0.43% to 14.71%. None of the snails collected from Talibon in Bohol was infected. Bohol is the only province among the 28 schistosomiasis-endemic provinces which has reached near elimination status. Snail infection rates were found to vary considerably across snail sites, which could be due to the degree of fecal contamination of the snail sites and their connectivity to water that can serve as contamination source.