Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis. Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=−0.41, R2=0.12). Conclusions We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

Methods: Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups. Results: Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group. Conclusions Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.

We report a rare case of anaphylaxis due to caffeine intake. A 27-year-old woman suffered her first episode of anaphylaxis and a positive skin prick test suggested that the anaphylaxis was due to an IgE-mediated hypersensitivity reaction to caffeine. She was diagnosed with caffeine allergy and has not had an allergic reaction after avoiding foods and drinks containing caffeine. Although caffeine is known to have antiallergic effects, this case shows that caffeine can be an allergen and cause anaphylaxis.
Adult ; Anaphylaxis ; Caffeine ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Skin

Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important；however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61［23-88］years；female/male, 9/19, body mass index, 25.0［18.0-33.6］kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points；P＜.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P＜.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.

Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important；however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61［23-88］years；female/male, 9/19, body mass index, 25.0［18.0-33.6］kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points；P＜.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P＜.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.

We are planning a study focused on the gathering of clinical data for the purpose of formalizing diagnostic logic at 6 institutions specialized in Kampo-based medical examinations. However, during the planning stage, it has been recognized that there are a large number of Kampo formulas to be studied, and differences among faculties and individuals exist regarding how to identify each Kampo formula, methods of gathering findings, and the evaluation of efficacy. Here we report the solution proposal reached after building consensus among all participating faculties on these issues. After raising the issues, conferences were held for each of them, until a unanimous consensus was obtained. As a result, the following conclusions were reached. Thirty-three Kampo formulas were selected as targets for the formalization of diagnostic logic. In addition, the range of dosage forms, crude drug ingredients, and permissible dosages for each Kampo formula were determined. Regarding clinical findings for these Kampo medicines, the items to be collected and evaluation criteria were also established. The criteria for evaluating the validity and safety of each Kampo medicine were decided, together with the grading and timing of evaluation. We hope that our solution proposal reached after building consensus becomes the basis for Kampo research in the future.