The patient was an 84-year-old man. On July 1, 20XX, he experienced great difficulty in walking. On July 3, he suffered from serious complaints of backache and hyperhidrosis and was rushed off to a nearby hospital. A blood test was performed immediately. It showed that all the values conformed to DIC criteria. (?) A ultrasound scan revealed phiebothrombosis in the deep part of the legs. CT using a contrast medium found iliopsoas muscle abscess and periaortitis. The man was diagnosed with DIC, multiple organ failue, septic shock, and deep part phiebothrombosis. Treatment was done with an antimicrobial medicine and immunoglobulin preparations. In addition, an anticoagulant therapy was performed using DOA and heparin. Inflammation began to subside gradually but his fever did not abate. Contrast enhanced CT indicated abscess all over the body. After a 34-day stay in the hospital, he died. Although this case occurred in an urban area, MRSA was detected in the patient, suggesting that this strain is now one of the omnipresent bacteria. In this respect, this case was significant. Generally, a drainage procedure is taken for the treatment of iliopsoas muscle abscess. However, in this case, a remedial drainage was not used because the diameter of abscess was so small. As his temperature did not fall, a diagnostic drainage should have been used.

It is generally accepted that visually impaired individuals generally have a low aerobic capacity, which may be partly attributed to a lack of physical activity, and have hypothesized that their response to exercise may differ from that of normal-sighted people. In this study, we investigated the effect of exercise on local immunity in the oral cavity in 24 visually impaired males (n=8 ; totally blind group, n=16 ; partially sighted group) and 8 normal-sighted males. The subjects performed submaximal graded bicycle ergometer exercise to an intensity of 75% heart rate max for 12 min. Before and immediately after exercise, we collected timed saliva samples and measured secretory immunoglobulin A (sIgA) .
The totally blind group had lower levels of aerobic capacity and a lower sIgA secretion rate compared to the partially sighted and sighted groups. Immediately after exercise, the sIgA secretion rate tended to increase in the totally blind group.
It is suggested that the exercise-induced response of local immunity in the totally blind group differed from that in the other groups.

Objectives: Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery.Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis. Methods: A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index. Results: DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of − 5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis. Conclusions OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.

Objective: This study aimed to reveal the prevalence and characteristics of anguish among delirious patients with advanced cancer receiving specialized palliative care services. Methods: We conducted a subanalysis of a multicenter, prospective, observational study at 14 inpatient palliative care units and 10 general wards that offered psycho-oncology consultation service in Japan. We consecutively enrolled the patients with advanced cancer who were diagnosed with delirium and prescribed antipsychotics. Palliative care specialists decided whether patients suffered from anguish or not. We assessed patients’ background and severity of delirium with the Delirium Rating Scale-Revised (DRS-R-98). Results: Of 818 enrolled patients, 99 (12.1%) suffered from anguish. We observed a significant difference in the mean age (68.9±12.6 vs. 72.1±11.2, p=0.009), prevalence of dementia (2% vs. 10.4%, p=0.005) between patients with anguish and those without anguish. Patients with anguish had lower DRS-R-98 total scores before medication than those without anguish (15.3±8.1 vs. 17.3±7.8, p=0.018), but higher severity score in lability of affect (1.2±0.8 vs 1.0±0.9, p=0.023). Conclusions: The results of this study suggested that patients with anguish tend to be younger, mostly do not have dementia, and have lower delirium severity score but higher score in lability of affect. Nevertheless, further research, investigating appropriate evaluations and medical interventions for patients with anguish is warranted.