Purpose The purpose of this study was to determine a preventive strategy for ankle sprain injury through a questionnaire survey of coaches of junior high school basketball teams. Participants and ...Methods The questionnaire comprised questions concerning coaches’ characteristics, prevention-related content, and collaboration with medical staff. We distributed the questionnaire to 108 coaches, of which 48 (41.7%) responded. Results The results revealed that none of the participant coaches had ever collaborated with medical staff. Conclusion Additional effort from medical staff is needed to hold seminars and contact coaches of junior high school teams in order to conduct an injury prevention program.
Background: The association between preoperative Prognostic Nutrition Index/Controlling Nutritional Status （PNI/CONUT） score and postoperative complications for cholecystitis is unclear. We evaluated ...the association among preoperative clinical status, including Charlson Comorbidity Index, American Society of Anesthesiologists‐physical status classification system （ASA‐PS）, Tokyo Guidelines 2018 （TG2018） severity grade, PNI, and CONUT, and postoperative complications for patients undergoing surgical treatment for cholecystitis. Results: Sixty‐seven patients undergoing surgery for cholecystitis diagnosed by TG2018 were enrolled in this study. Sixty patients underwent laparoscopic cholecystectomy （42 were completed by laparoscopic and 18 were converted to open surgery）, and seven patients underwent initially open cholecystectomy. Nine patients had postoperative complications （Clavien‐Dindo Grade Ⅲ or more）. There was a significant association between postoperative complications and being in the preoperative low‐PNI （＜40） group compared with the high‐PNI （≥40） group （78％ vs. 22％, p＝0.038）, and being in the preoperative high‐CONUT group （score ≥5, moderate and severe） compared with being in the low‐CONUT group （score ≤4, normal and light） （67％ vs. 33％, p＝0.043）. There was no significant association between postoperative mortality （n＝2） and preoperative factors；however, the patients had low PNI （＜40）. Preoperative body mass index, albumin, total lymphocytes, and total cholesterol were not significantly associated with postoperative complications or mortality. Conclusion: Evaluation of preoperative PNI and CONUT may be predictive factors for postoperative complications undergoing surgery for cholecystitis.
Aim
The risk of developing infectious diarrhea among elderly residents at Japanese geriatric intermediate care facilities is unclear. We investigated the incidence rate and risk factors of ...norovirus‐related diarrhea at such facilities.
Methods
This prospective cohort study followed 1727 residents from November 2018 to April 2020 at 10 geriatric intermediate care facilities in Osaka, Japan regarding the occurrence of diarrhea. Resident data were collected from their medical records using structured forms at two to three of the following three time points: at recruitment, if they developed diarrhea, and when they left the facility. Residents who developed diarrhea were tested using rapid diagnostic tests for norovirus. Cox proportional hazard model was employed to hazard ratios (HRs) with 95% confidence intervals (CIs) to estimate the risk factors for norovirus‐related diarrhea.
Results
During the study period, 74 residents developed diarrhea, 13 of whom were norovirus positive. The incidence rate of norovirus‐related diarrhea was 10.11 per 1000 person‐years (95% CI: 4.61–15.61). In terms of risk factors, people with care‐needs level 3 were at a higher risk for developing norovirus‐related diarrhea (adjusted HR aHR = 7.35, 95% CI: 1.45–37.30). Residents with hypertension (aHR = 3.41, 95% CI: 1.05–11.04) or stroke (aHR = 8.84, 95% CI: 2.46–31.83), and those who walked with canes (aHR = 16.68, 95% CI: 1.35–206.52) also had a significantly higher risk for norovirus‐related diarrhea.
Conclusions
Throughout the study period, the incidence of development of diarrhea was low. Care‐needs level 3, stroke, hypertension and use of a cane were identified as risk factors for norovirus‐related diarrhea in Japanese geriatric intermediate care facilities. Geriatr Gerontol Int 2023; 23: 179–187.
The study aimed to investigate the incidence rate and risk factors of norovirus‐related diarrhea at Japanese geriatric intermediate care facilities. The incidence rate of norovirus‐related diarrhea was 10.11 per 1000 person‐years, and people with care‐needs level 3, stroke, hypertension and use of a cane were identified as risk factors for norovirus‐related diarrhea.
Purpose The Gait Judge System measures the plantar flexion resistive torque acting on the angle of the ankle joint, as well as the ankle joint itself, of the ankle-foot orthosis using a 1,000 Hz ...sampling frequency. This pilot study aimed to determine the characteristics of plantar flexion resistive torque acting on the double Klenzak ankle joint of the ankle-foot orthoses worn by healthy individuals. Participants and Methods Participants were eight healthy young adults (3 male, 5 female; mean age, 26.8 years old; mean height, 165 cm.; mean body weight, 56.3 kg). Plantar flexion resistive torques and angles of the ankle joint in gait cycles were measured with the Gait Judge System. Speed of gait was calculated using a ruler attached on the floor and the Gait Judge System video. We classified waveforms according to the existence of second peaks in the gait cycle. The correlations between parameters related to the plantar flexion resistive torque and the speed of gait were evaluated using Pearson’s simple correlation analysis. Results The plantar flexion resistive torque showed two peaks: the first peak was at the loading response, measured at 17.4 Nm, and the second peak was at the pre-swing phase, measured at 10.9 Nm. However, the second peak was absent in three of the participants. The normalized second peak and the second peak/first peak ratio had a strong, positive correlation with the speed of gait. Conclusion The Gait Judge System revealed typical waveforms according to the parameters set in this study.
•Immunogenicity of BNT162b2 vaccine were evaluated using two immunoassays.•Elderly Japanese residents showed lower antibody responses than staff.•Aging, steroid and NSAID usage are independent risk ...factors for lower responses.
To evaluate antibody responses against the primary series of vaccination of severe acute respiratory syndrome coronavirus-2 SARS-CoV-2 vaccines in the staff and residents of Japanese geriatric intermediate care facilities.
All subjects (159 staff and 96 residents) received two doses of the BNT162b2 mRNA vaccine 3 weeks apart. Baseline data of subject were collected using a structured form. Serum samples were collected three times: before vaccination, 3 weeks after the first dose, and 4 weeks after the second dose, and anti-receptor binding domain of the spike protein of SARS-CoV-2 anti-RBD IgG was measured using two immunoassays.
After the second dose, geometric mean titers GMT of anti-RBD with both the Abbott and Roche assay were significantly lower in residents than staff (2282 AU/mL vs. 8505 AU/mL, and 258 U/mL vs. 948 U/mL, respectively). Multivariate analysis of characteristics affecting antibody responses (≥1280 AU/mL for Abbott and > 210 U/mL for Roche) showed lower odds ratios ORs for older age (adjusted OR per 10 year increase aOR = 0.62, 95 % confidence interval 95 %CI; 0.38–1.02), steroid usage (aOR = 0.09, 95 %CI; 0.01–0.60) and regular nonsteroidal anti-inflammatory drugs NSAIDs usage (aOR = 0.16, 95 %CI; 0.03–0.88).
Elderly people and steroid and NSAID users had lower antibody responses following the second vaccine dose.
Sumida M, Fujimoto M, Tokuhiro A, Tominaga T, Magara A, Uchida R. Early rehabilitation effect for traumatic spinal cord injury. Arch Phys Med Rehabil 2001;82:391-5. Objective: To determine the ...natural course of traumatic spinal cord injury (SCI) and the effect of early rehabilitation on it. Design: A retrospective, multicenter study. Setting: Sixteen Rosai hospitals and 1 medical school. Participants: One hundred twenty-three SCI patients (104 men, 19 women; mean age, 48.8 ± 17.7yr) enrolled. Interventions: Dividing the subjects into an early rehabilitation group and a delayed group; differences were ensured by international classification of SCI. Main Outcome Measures: Using the American Spinal Injury Association (ASIA) classifications, the motor recovery rate (MRR) was defined as (ASIA motor score at discharge — ASIA motor score at admission)/(100 — ASIA motor score at admission). The regression lines for FIM™ instrument score and ASIA motor score were determined for 6 subgroups (early or delayed tetraplegia, central cord injury, paraplegia) by the MRR staging. The regression lines for physical or cognitive FIM score and ASIA motor score were also determined for 6 subgroups. Results: Three stages were obtained: acute stage: 2 weeks postinjury; recovery stage: 2 weeks to 6 months postinjury; and chronic stage: more than 6 months postinjury. Regression lines showed that rehabilitation improved physical functional independence for ASIA motor score, especially in the early rehabilitation subgroups. There was no correlation between cognitive FIM score and ASIA motor score in 6 subgroups. Conclusion: Early SCI rehabilitation contributes to good physical activities of daily living for motor function.
Purpose. To develop a screening test to identify community dwelling elderly people who are in need of assistive care but whose activities of daily living (ADLs) can be improved by appropriate ...rehabilitation intervention, so-called 'quasi-in-need-of-care state (QUINOCS)'.
Method. A total of 32 persons (mean age 77.3 years) from the metropolitan area and 51 persons (mean age 82.7 years) from a rural area were enrolled. Two physiatrists examined them and judged whether they could benefit from rehabilitation intervention while visiting nurses evaluated their ADLs using the Functional Independence Measure (FIM™). A screening test to identify the QUINOCS was created using a seven-item subset score of the FIM™ (feeding, bathing, dressing lower-body, bladder management, bed chair wheel chair transfer, walking wheel chair, stairs).
Results. Fourteen in the metropolitan and 19 in the rural inhabitants were judged as the QUINOCS by the physiatrists. Persons whose subset scores included or ran across the intermediate range of independent levels (scores 3 and 4 of the FIM™) showed tendency to be judged suitable for rehabilitation intervention. This finding was applied for screening algorism to identify the QUINOCS. Sensitivity and specificity of this test were 0.71 and 0.78 for the metropolitan, and 0.74 and 0.78 for the rural groups, respectively.
Conclusion. The screening method using the 7-item subset of the FIM™ can be used for identification of the QUINOCS among elderly people efficiently.
Abstract
Background
Norovirus infection and Clostridioides difficile infection (CDI) are major causes of acute infectious diarrhea at medical facilities. “Geriatric intermediate care facilities” are ...a type of medical facility that tend to the daily life needs of elderly Japanese people. However, there is no research about norovirus- or CDI-related diarrhea at Japanese geriatric intermediate care facilities.
Methods
This prospective cohort study included 1445 residents at 10 geriatric intermediate care facilities in Osaka between November 2018 and October 2019. The study subjects were followed regarding the occurrence of acute infectious diarrhea and the results of rapid diagnostic tests for norovirus and CDI. We calculated incidence rates and hazard ratios (HR) with 95% confidential intervals (CI) to identify the risk factors of infectious diarrhea.
Results
Thirty-seven residents developed diarrhea during the observation period, although none of them was positive for norovirus or CDI. The total incidence rate was 1.21/10,000 person-days (95%CI: 0.82-1.60). Compared with residents aged 87-91 years, those aged ≤ 80 years had a significantly higher risk of diarrhea (HR = 3.85, 95%CI: 1.27-11.66). Moreover, residents with thyroid diseases had a significantly higher risk of diarrhea than those without thyroid disease (HR = 5.33, 95%CI: 2.32-12.25).
Conclusions
The incidence of acute infectious diarrhea is relatively low. However, residents who are < 80 years old and those with thyroid diseases are more likely to develop diarrhea.
Key messages
We describe the situation of acute infectious diarrhea at Japanese geriatric intermediate care facilities
Abstract. Purpose The purpose of this study was to determine a preventive strategy for ankle sprain injury through a questionnaire survey of coaches of junior high school basketball teams. ...Participants and Methods The questionnaire comprised questions concerning coaches' characteristics, prevention-related content, and collaboration with medical staff. We distributed the questionnaire to 108 coaches, of which 48 (41.7%) responded. Results The results revealed that none of the participant coaches had ever collaborated with medical staff. Conclusion Additional effort from medical staff is needed to hold seminars and contact coaches of junior high school teams in order to conduct an injury prevention program.
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