An 81-year-old man with complaints of dysphagia and weight loss was admitted to our hospital. Upper gastrointestinal endoscopy revealed advanced gastric cancer. Fever of unknown origin with leukocytosis persisted after admission. A granulocyte-colony stimulating factor (G-CSF)-producing gastric cancer was suspected because of elevated serum G-CSF levels. Surgery was performed in spite of the patient’s poor general condition. He went into acute respiratory distress from aspiration pneumonia after surgery and respiratory management with assisted ventilation was needed. Enteral feeding was difficult initially, but oral intake could eventually be resumed. The patient’s condition improved sufficiently to be discharged.

A 79-year-old woman with an infected pressure ulcer was admitted to our hospital. She had depression and poor nutritional status due to drug-induced dysphagia. To facilitate treatment of the pressure ulcer, improvement of nutritional status was preferable. Adjusting the psychotropic drugs led to improvement of both oral intake and the pressure ulcer. To prevent recurrence of pressure ulcer, the medical treatment environment needed to be improved. An important consideration was where she would receive medical treatment after discharge and included considering the burden on caregivers and the economic burden that this would impose. This case shows that a multifaceted approach can be effective for treating infected pressure ulcer in a patient with poor nutritional status and mental illness.

It is very important to cooperate with interprofessional personnel is in order to establish the community-based integrated care system, but this is very difficult. We have held comprehensive consultation services regarding medical, welfare, and legal problems to support the community.Objectives: This study aimed to identify the associations between background factors (such as medical conditions, intractable diseases, welfare problems, disabilities, economic difficulties, legal problems, elderly adults, children, and foreign persons) and difficult cases to provide more thorough consultation services.Patients and Methods: A survey was conducted on people who participated in comprehensive consultation services on medical, welfare, and legal issues related to medical care, welfare, and legal matters held from April 2021 to March 2024. We analyzed risk factors that may be difficult to resolve using multivariate logistic regression.Results: Multivariate analysis showed that the factor of “economic difficulty” was significantly more difficult to solve.Conclusion: When treating patients, doctors must consider the possibility of multiple underlying issues. It is advisable for doctors to be aware of the need to consult with social workers and legal professionals when necessary.