Objectives: Peripherally inserted central venous catheter (PICC) is widely used, because the incidence of complications and bloodstream infection in patients receiving PICC was lower than that in patients receiving central venous catheter. We compared PICC between cancer patients and non-cancer patients. Methods: This retrospective single-center study included 157 patients receiving PICC from May 2012 to September 2015. Patients were separated into cancer and non-cancer groups. Results: Cancer patients were 88 and non-cancer patients were 69. The most common causes of PICC were intravenous hyperalimentation (Cancer vs. non-cancer: 45 vs. 51) and difficult peripheral venous access (40 vs. 12) (p=0.0022). The duration of catheterization was 15 (6-39) vs. 21 (12-40) days (p<0.0001). The causes of catheter removal were death (50 vs. 14), remission (9 vs. 26), redness on insertion site or infection suspicion (10 vs. 11), and Some kind of catheter trouble (8 vs. 4) (p=0.0002). Complications occurred in 8 vs. 9 patients (p=0.429), and infection occurred in 0.9 vs. 2.0/1000 catheter days (p=0.041). Discussion: End-stage cancer patients have a weakened immune system. In this study, the incidences of PICC-related infection and other complications were not different between cancer and non-cancer patients, suggesting PICC was a safer method.

  The purpose of this study was to accumulate fundamental data for use in the future project for preventing or delaying institutionalization of the aged by clarifying the relationship between the Kihon Checklist and bone density. All the subjects were residents of the southern part of Akita Prefecture in the 65-74 age band. The Kihon Checklist was used. The women who marked the items on the list related to “intraoral conditions” tended to be low in bone density. Those who checked off the items related to “oral functions” -- the standard of judgment in determining the level of care needed - were inactive and depressed.   Since bone density was an indicator of whether the elderly women were in need of nursing care, we thought it of paramount importance to encourage them to participate in the screening for osteoporosis on a regular basis and to take measures to maintain or improve bone density.

Introduction: Due to the advancement of the home-based healthcare, increasing the number of professionals who are able to administer homebased treatments, such as endotracheal suctioning, is an urgent issue.Methods: By measuring the ocular movement of nurses, nursing students and previous researches, an endotracheal suctioning ontology was visualized. It included a multiplex task structure, recognition, and judgment, as well as identifying procedures used during endotracheal suctioning that could contribute to a discussion on educational feasibility.Results: From the hierarchical structure of the constructed endotracheal suctioning ontology, not only the procedural knowledge but also knowledge about medical devices, knowing what options exist when endotracheal suctioning is ineffective, and a wide range of other expertise is needed to perform endotracheal suctioning safely.Discussion: An endotracheal suctioning ontology was created from the ocular movement of nurses. Ontologies are a potential tool for defining minimum requirements and the scope of ability that must be evaluated before clinical practicum.

Objective: Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is important due to concerns regarding infectivity, transmissibility, immune evasion and disease severity. We evaluated the temporal and regional replacement of previous SARS-CoV-2 variants by the emergent strains, Alpha and Delta. Methods: We obtained the results of polymerase chain reaction screening tests for variants conducted in multiple commercial laboratories. Assuming that all previous strains would be replaced by one variant, the new variant detection rate was estimated by fitting a logistic growth model. We estimated the transmission advantage of each new variant over the pre-existing virus strains. Results: The variant with the N501Y mutation was first identified in the Kinki region in early February 2021, and by early May, it had replaced more than 90% of the previous strains. The variant with the L452R mutation was first detected in the Kanto-Koshin region in mid-May, and by early August, it comprised more than 90% of the circulating strains. Compared with pre-existing strains, the variant with the N501Y mutation showed transmission advantages of 48.2% and 40.3% in the Kanto-Koshin and Kinki regions, respectively, while the variant with the L452R mutation showed transmission advantages of 60.1% and 71.9%, respectively. Discussion In Japan, Alpha and Delta variants displayed regional differences in the replacement timing and their relative transmission advantages. Our method is efficient in monitoring and estimating changes in the proportion of variant strains in a timely manner in each region.

A fungal carotid aneurysm is an infrequently occurring infectious aneurysm that is usually treated by antifungal therapy plus surgical debridement of the infected vessel. We herein report an extremely rare case involving a patient with a medical history of bladder cancer treated by Bacillus Calmette– Guérin (BCG) who developed a fungal aneurysm of the internal carotid artery and thrombosis of the superior ophthalmic vein caused by maxillary Aspergillus sinusitis. The patient was successfully treated by antifungal, anticoagulant, and antiplatelet drugs combined with internal carotid artery ligation therapy. Internal carotid artery fungal aneurysm is associated with a high mortality rate, but the present case suggests that it can be successfully treated by antifungal therapy combined with a less invasive endovascular therapy.