Purpose：To clarify factors related to changes in activities of daily living (ADL) among elderly patients who were discharged to home.

Methods：The subjects were 88 persons who received in-hospital musculoskeletal rehabilitation and discharged to home. Factors related to changes in functional independence measure (FIM) score were examined.

Results：The factors related to restoring the FIM score to its values before hospitalization were frequency of physical exercise at 1 week (odds ratio [OR] ＝1.41) and 1 month (OR＝1.27) after hospital discharge, restoring the FIM score at hospital discharge to its value before hospitalization (OR＝3.96), and feeling of self-efficacy (OR＝1.16) at 3 months after hospital discharge. A receiver-operating characteristic analysis revealed that the factors related to restoring the FIM score to its value before hospitalization were frequency of physical exercise (cutoff value＝1.5) at 1 week after discharge, frequency of physical exercise (cutoff value＝1.0) at 1 month after discharge, and feeling of self-efficacy (cutoff value＝31.5) at 3 months after discharge. In addition, ≥ 2 days of physical exercise per week after hospital discharge was more likely to lead to high FIM score than ＜ 2 days of physical exercise per week.

Conclusion：Our results implied that regular physical exercise soon after hospital discharge would lead to better prognosis

Syncope is a common chief complaint in emergency departments, and although causes in most patients with syncope are benign, some patients have a serious disease. Here we report a 50-year-old patient with facial trauma who had past history of alcoholic liver cirrhosis. He fell down by syncope due to portopulmonary hypertension (PPHTN) accompanied by portal hypertension. Oral ambrisentan, a potent ET_A-selective receptor, 2.5 mg once a day was initiated. His ECG and the results of cardiac catheterization showed improvement in hemodynamic abnormality after the treatment. Also, the patient had no significant symptoms, including syncope, for nine months after receiving ambrisentan.

The reform of the way physicians work was started from April 2024. Restrictions on doctors' working hours is expected to be difficult to achieve the level required by the government. U40 Kyushu-Okinawa Branch conducted a questionnaire survey of young cardiovascular surgeons nationwide on their working conditions. While some institutions have taken measures such as streamlining doctors' work and shifting tasks, others seem to have made a few change to their previous work content. The reform of work styles of cardiovascular surgeons requires not only individual improvement of work styles, but also efforts by cardiovascular surgeons as a one team, including department heads and facility directors, and requires the involvement of academic societies and governments.

Purpose：To clarify factors associated with self-efficacy in elderly patients discharged from the hospital to their homes.Methods：The subjects comprised 88 patients who had received in-hospital rehabilitation for musculoskeletal disease and were discharged to their homes. Factors associated with self-efficacy were examined. The self-efficacy scale score was determined using the hierarchical cluster analysis, and significant differences in characteristics were examined through multiple comparisons. Multiple regression analysis was used to evaluate self-efficacy associated with the frequencies of “going out” and “physical exercise” at 1 week, 1 month, and 3 months after discharge.Results：Self-efficacy 3 months after discharge was significantly associated with female sex, age, non-social role, length of hospital stay, cognitive decline, and relative functional efficiency. In addition, higher frequencies of “physical exercise” or “going out” were more likely to result in higher self-efficacy than lower frequencies of “physical exercise” or “going out.”Conclusion：The results suggest that physical activity is associated with self-efficacy and that the difference in the contents of the physical activity relates to self-efficacy.