BACKGROUND: The Rugby World Cup (RWC) is one of the biggest international mega sports events in the world. This study was conducted to identify and evaluate the volume, nature, and severity of spectator medical care in the stadiums of 12 venues across Japan during RWC 2019. METHOD: This was a retrospective review of medical records from spectator medical rooms of 45 official matches of RWC 2019 between September 20 and November 2, 2019. All patients in the stadium who visited the spectator medical room and were transferred to a hospital were included. The wet bulb globe temperature (WBGT) value at the kick-off time of each match, the number of visits to the spectator medical room, and the number of transfers to a hospital were reviewed and analyzed. The patient presentation rate (PPR) was calculated per 10,000 attendees. Severity categories were defined as mild or severe. Mild cases were considered non-life threatening requiring minimal medical intervention, and severe cases required transport to a hospital. RESULT: The total number of visits to the spectator medical room was 449 with a PPR of 2.63. Most cases (91.5%) were mild in severity. The PPR was significantly higher for the matches held with a WBGT over 25 °C than for the matches under 21 °C (PPR 4.27 vs 2.04, p = 0.04). Thirty-eight cases were transferred to a hospital by ambulance; the PPR was 0.22. The most common reasons for transfer to the hospital were heat illness and fracture/dislocation, at a rate of 15.8% each. The incidence rate of cardiopulmonary arrest per 10,000 attendees was 0.0059 during RWC 2019. CONCLUSION Preparation and provision of appropriate medical service for spectators is a key factor for mass-gathering events. During RWC 2019, the majority (91.5%) of patients who sought medical attention did so for minor complaints, which were easily assessed and managed. On the other hand, a higher WBGT situation contributes significantly to an increased PPR (< 21 versus > 25, 2.04 versus 4.27, p = 0.04). Careful medical preparation, management, and development of public education programs for higher WBGT situations will be required in the future for similar international mega sports events.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care/statistics & numerical data* ; Anniversaries and Special Events ; Child ; Child, Preschool ; Emergency Service, Hospital/statistics & numerical data* ; Female ; Football ; Hospitalization/statistics & numerical data* ; Humans ; Infant ; Infant, Newborn ; Japan ; Male ; Mass Behavior ; Middle Aged ; Retrospective Studies ; Young Adult

In many patients with pulmonary cryptococcosis, chest radiographs show solitary or multiple nodular shadows, but pulmonary cryptococcosis with a large mass is rare. A previously healthy 45-year-old man presented to the hospital complaining of fever and cough. Contrast-enhanced computed tomography showed a tumor shadow with a long diameter of 64 mm in the lower lobe of the right lung. We considered the possibility of a lung abscess, but because it was refractory to antibiotics, we suspected the possibility of a malignant tumor. Transbronchial biopsy was performed, and Cryptococcus neoformans was detected. There were no complications of meningitis or immune deficiency, including acquired immune deficiency syndrome. He was administered antifungal drugs, and shrinkage of the shadow was achieved. Pulmonary cryptococcosis should also be considered when a large lung mass is observed.

1) Japan Society for Medical Education launched a committee for the graduate education of medical educationists in Japan. The committee proposed a direction toward establishing the system, by way of discussion among the members, needs assessment, information gathering of overseas master courses, and discussion at the open meeting.2) To promote medical education in Japan, we should establish 2 systems concurrently: (1) a graduate education for medical educationists who have a broad base of theories and can lead future medical education, and (2) a broader certificate system for medical teachers who have good practical teaching skills.

1) The committee for the graduate education of medical educationists, Japan Society for Medical Education, investigated needs for the education system of medical educationists.2) A questionnaire was sent to 1831 leaders in healthcare education and the society members, and 644 replied (recovery rate 35.2%). Fifty % of the respondents agreed the necessity of medical educationists. Certificate level was most popular, however, master and PhD degrees were also considered to be necessary. 3) These results support the establishment of educational system for medical educationists in Japan.