Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

On 26 May 2024, the Panel Discussion 2 " Cooperation between medical doctors and acupuncturists: With a view to future medical care " was held at the 73rd Annual Meeting of the Japan Society of Acupuncture and Moxibustion was held in Sendai, Miyagi, Japan. Three panelists presented the attempts of cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan, including the fact that acupuncture and moxibustion have been successful in improving and alleviating patients' illnesses and symptoms in psychiatry, general internal medicine and palliative medicine, contributing to shorter hospital stays for patients, and the challenges for cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan. A designated speaker also presented on the development of highly specialized acupuncturists at the Japan Society of Acupuncture and Moxibustion to establish cooperation between medical doctors and acupuncturists, among others. Finally, we discussed issues and future prospects for cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan, with a view to future medical care where acupuncture and moxibustion will be utilized. One of the challenges in improving the utilization rate of acupuncture and moxibustion in Japan is the cooperation between medical doctors and acupuncturists at medical institutions and medical field. This report summarizes the contents of this panel discussion.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

Objective: To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment. Methods: An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors. Results: The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006). Conclusion Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.

A woman in her 60 s presented with chest pain. The electrocardiography showed ST depressed in V3-V6, ST elevation in aVR, and negative T in I, II, aVL, and aVF. Laboratory examination revealed that creatinine kinase isoenzyme-MB and troponin I were elevated. Transthoracic echocardiography revealed moderate aortic regurgitation. Enhanced computed tomography did not show an aortic dissection. Acute coronary syndrome was suspected and cardiac catheterization was done. Aortography showed an intimal flap inside the Valsalva sinus. An emergency operation was performed. Surgical view: the intimal tear affected almost all the circumference of the aorta in the Valsalva sinus and the aortic dissection with a localized and moving intimal flap affected the coronary flow and the aortic dissection caused severe aortic regurgitation and decreased the coronary flow. An aortic root replacement was successfully performed, and the postoperative course was uneventful.