Objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant B.1.1.529 (Omicron) was first detected in Japan in November 2021. In Osaka, public health centres subsequently increased active case finding and encouraged self-isolation. This study investigated the effectiveness of these countermeasures. Methods: Cases targeted for analysis were persons who had neither recently travelled abroad nor had contact with foreign tourists but tested positive for SARS-CoV-2 between 24 November 2021 and 4 January 2022 and were suspected or confirmed to have the Omicron variant. We performed a descriptive analysis and calculated the reproduction number (R) for each generation using the branching process method. Genomic sequencing data were analysed to plot a haplotype network. Results: A total of 251 cases were analysed. The median age was 30 years, and 46% (115/251) were in their 20s or younger. The first Omicron case in Osaka was detected on 21 December 2021. Local public health centres conducted health monitoring and contact tracing. We analysed R, using information from six clusters, including 42 pairs with a clear relationship between the case and the infected contact (infector–infectee pairs); the clusters had 19, 21 and 2 cases in each subsequent generation. The basic R (t = 0) was estimated to be 3.2, and subsequent generations (t = 1, 2) of R decreased to 1.1 and 0.1, respectively. The haplotype network showed that these cases constituted a monophyletic group with others detected around Osaka, indicating that these case-related clusters had been contained and were not involved in the nationwide Omicron waves. Discussion: Active case finding and self-isolation were found to be effective in limiting the spread of an emerging novel variant.

Adrenal venous sampling (AVS) is the key procedure for lateralization of primary hyperaldosteronism (PA) before surgery. Identification of the adrenal veins using computed tomography (CT) and intraoperative cortisol assay facilitates the success of catheterization. Although administration of adrenocorticotropic hormone (ACTH) has benefits such as improving the success rate, some unilateral cases could be falsely diagnosed as bilateral. Selectivity index of 5 with ACTH stimulation to assess the selectivity of catheterization and lateralization index (LI) >4 with ACTH stimulation for unilateral diagnosis is used in many centers. Co-secretion of cortisol from the tumor potentially affects the lateralization by the LI. Patients aged <35 years with hypokalemia, marked aldosterone excess, and unilateral adrenal nodule on CT have a higher probability of unilateral disease. Patients with normokalemia, mild aldosterone excess, and no adrenal tumor on CT have a higher probability of bilateral disease. Although no methods have 100% specificity for subtype diagnosis that would allow bypassing AVS, prediction of the subtype should be considered when recommending AVS to patients. Methodological standardization and strict indication improve diagnostic quality of AVS. Development of non-invasive imaging and biochemical markers will drive a paradigm shift in the clinical practice of PA.

Objective: In Japan, the healthcare authority encourages physicians to prescribe generic drugs in order to reduce the copayments by the patients for pharmaceutical expenses and to improve the financial status of the national medical insurance system.  In accordance with this governmental policy, we have been actively involved in switching original to generic formulations.  Thus, Utemerine® 50 mg injection was replaced with Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.  There have been some reports on adverse events caused by the generic formulations of Ritodrine hydrochloride.  Factors contributing to these adverse effects may include different additives and/or vehicles and the exemption of demonstrating some conditions for approval, including clinical trials.  Therefore, in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation and to decide on its continued use, we carried out a retrospective cohort study.
Methods: We carried out a retrospective cohort study in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation.
Results: There were no significant differences in the length of hospital stay, rate of emergency transport to other institutions, gestational week of delivery, rate of stillbirth, rate of abortion, or incidence of adverse events between the two formulations.
Conclusion: Our results may contribute to the safe and secure use of the generic formulations of Ritodrine hydrochloride in the current situation of the increasing use of generic drugs in health care.  Although there are some limitations in our study, the results suggest that there are no particular problems with the continued use of Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.

　　When we use haloperidol (HP) parenterally to treat delirium in cancer patients, sometimes akathisia appears. So, we are pressed to give treat this symptom. The aim of this study was to investigate the occurrence rate of akathisia after HP injection and the effectiveness of biperiden injection in the treatment of akathisia. 　　We retrospectively worked out the rate of the use of Hp injection, the rate of the occurrence of akathisia by using Hp and the effectiveness of biperiden injection in the treatment for delirium in 67 patients out of 100 patients who died in the palliative care unit (PCU) and 10 patients with delirium out of 23 patients who were under care of our palliative care team (PCT) in the sections other than the PCU from August to December of 2012. In the PCU, Hp injections were used in 52 patients (78%) out of 67 with delirium, and akathisia was suspected in 23 patients. Biperiden was injected into all of them and it was effective in 21 patients (91%). Our palliative care team gave Hp injections to seven patients (70%) out of 10 with delirium, and akathisia was suspected in one patient. At that time Hp injection was suspended but biperiden was not used. To sum up, Hp was administered to a total of 59 patients (76%) out of 77 with delirium, and akathisia was suspected in 24 patients (40%). Biperiden was used in 23 patients, all of whom were PCU patients, and effective in 21 (91%). 　　When Hp was used to treat cancer patients with delirium, the onset of akathisia was suspected in 40% of them, but biperiden was considerably beneficial in patients with delirium.

　　Persons who are abused often have serious problems in a complicated life situation. We studied this issue and considered ways in which medical social workers (MSWs) handle these social problems. We collected data in 16 cases of elderly abuse that were managed by staff at our hospital from 2010 to 2013 and compared the characteristics in these cases with those of 23 cases of child abuse during the same period. Data analysis revealed 3 characteristics of abused persons: insufficient use of long-term care insurance service; mental disorder such as dementia or mental illness; and financial problems. Further detailed analysis found that intervention for elderly abuse cases was requested only in more difficult cases when abuse was easily identified by our staff. Therefore, staff’s awareness and motivation to become more involved in cases of elderly abuse may be low compared with cases of child abuse. Hospital staff are in a position where they should be able to readily identify maltreatment of aged persons. We need to develop a mechanism for the early detection of elderly abuse so staff can intervene easily in mild cases of elderly abuse, and ask for assistance from MSWs in more difficult cases. It is important to ensure that all employees have access to MSWs in the hospital.

No abstract available.

"Locomotive syndrome" is used to designate the condition of individuals with musculoskeletal disease who are highly likely to require nursing care. This article reviews screening, prevalence, causal and related factors, and the relationship between locomotive syndrome and falls and fractures in older adults with this syndrome. A few self-administered questionnaire tools are available to assess individuals for locomotive syndrome. Additionally, screening methods, including a physical functioning assessment, are appropriate for detailed discrimination of locomotive syndrome. The prevalence of locomotive syndrome is significantly higher in women than in men, and tends to increase markedly from 70 years of age. More severe locomotive syndrome is related to knee pain, osteoporosis, sarcopenia, and lumbar disease. The incidence of falling in locomotive syndrome is higher than the incidence for the older population in general. Locomotive training including squats and a unipedal standing exercise has been recommending to prevent locomotive syndrome. This training improves muscle strength and balance function for older people who have a risk for locomotive syndrome.
Accidental Falls* ; Adult ; Aged* ; Asian Continental Ancestry Group* ; Discrimination (Psychology) ; Female ; Humans ; Incidence ; Knee ; Male ; Mass Screening ; Muscle Strength ; Musculoskeletal Diseases ; Nursing Care ; Osteoporosis ; Prevalence ; Sarcopenia

The objective of this study was to examine whether the combination of n-3 polyunsaturated fatty acids PUFA) supplementation and physical exercise training would decrease oxidative stress in comparison with n-3 PUFA supplementation only in humans. Eighteen women college students were divided into a perilla oil supplemented control group or a perilla oil supplemented physical exercise trained group throughout the experimental period of 4 weeks. After the intervention in both groups, plasma triglyceride levels were decreased. Serum thiobarbituric acid reactive substances (TBARS) level in the control group was increased by n-3 PUFA supplementation. In the trained group, however, TBARS level was unchanged. Plasma vitamin C level in the trained group was significantly decreased by n-3 PUFA supplementation. These results suggest that the combination of n-3 PUFA supplementation and physical exercise training might result in attenuated tissue damage induced by reactive oxygen species, if appropriate daily antioxidants, especially vitamin C, were provided.