It is very important to cooperate with interprofessional personnel is in order to establish the community-based integrated care system, but this is very difficult. We have held comprehensive consultation services regarding medical, welfare, and legal problems to support the community.Objectives: This study aimed to identify the associations between background factors (such as medical conditions, intractable diseases, welfare problems, disabilities, economic difficulties, legal problems, elderly adults, children, and foreign persons) and difficult cases to provide more thorough consultation services.Patients and Methods: A survey was conducted on people who participated in comprehensive consultation services on medical, welfare, and legal issues related to medical care, welfare, and legal matters held from April 2021 to March 2024. We analyzed risk factors that may be difficult to resolve using multivariate logistic regression.Results: Multivariate analysis showed that the factor of “economic difficulty” was significantly more difficult to solve.Conclusion: When treating patients, doctors must consider the possibility of multiple underlying issues. It is advisable for doctors to be aware of the need to consult with social workers and legal professionals when necessary.

Utilizing data presented in the article by Miyashita et al., we illustrate the importance of testing data when assessing surveillance data. Accounting for the number of tests (denominator) and positivity (proportion of tests positive for a specific pathogen(s)) improves data interpretation in ways not possible from numerator case data alone.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

In this revision, we have attempted to align the Model Core Curriculum for Medical Education competency, "problem-solving ability based on specialized knowledge," with the "Standards of National Examination for Medical Practitioners." The major diseases and syndromes in "Essential Fundamentals" correspond to the basic diseases in Table 1 of the Core Curriculum, symptoms, physical and laboratory examinations, and treatment in "General Medicine" correspond to the items in Table 2 of the Core Curriculum, and the diseases in "Medical Theory" correspond to the diseases in PS-02 of the Core Curriculum. The validity of the diseases in the Core Curriculum was verified using the evaluation results of the examination level classification of the "Research for Revision of National Examination Criteria." Approximately 690 diseases were conclusively selected. This revision mentions the number of diseases in the Core Curriculum for the first time. Hopefully, this will lead to a deeper examination of diseases that should be studied in medical schools in the future.

Background/Aims: The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unit is desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay among outpatients. Methods: We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at the Toyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depression during endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100 minutes) were identified using multiple logistic regression analysis. Results: We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested without sedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and non-sedation group was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI, 1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results for colonoscopy. Conclusions Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.