Introduction: The aim of this study was to consider the definition of solitary death by examining characteristics of cases, and to explore the impact of the coronavirus pandemic.

Methods: Subjects were individuals with post-mortem examination and autopsy imaging data recorded between 2017 and 2022. Subjects were classified by whether they passed away at home (solitary). We investigated differences between groups in their causes of death, time elapsed between death and discovery, presence or absence of housemates, and prior symptoms.

Results: There were 129 cases (79.9%) of solitary death and 41 cases (24.1%) of death outside the home. Solitary death cases were significantly younger. Among these, less than half were discovered more than a day after death, lived alone, or were older adults. Older adults and those discovered more than a day after death were more likely to have trauma as their official cause of death. The frequency and characteristics of solitary death did not change before or after the coronavirus pandemic.

Conclusion: Preventive measures for solitary death should not be limited to older adults or those living alone. In particular, deaths from diseases other than sudden death, trauma in older adults, and cases where symptoms were present or medical attention was sought before death are potentially preventable. Countermeasures for solitary death are important in the post-coronavirus pandemic period.

Introduction: The purpose of this study was to clarify the relationship between the available service information on small-scale multifunctional in-home nursing care (KANTAKI) and its operational status via text mining.

Methods: We obtained nationwide textual information on KANTAKI from the Nursing Care Service Information Disclosure System and the Ministry of Health, Labour, and Welfare, and analyzed the characteristics of the word usage using KH Coder. The number of users and employees and the implementation of services were compared among the facilities that used terms relating to medical dependency and end-of-life care, which are KANTAKI characteristics, and with other facilities.

Results: The facilities that used terms relating to medical dependency and end-of-life care showed significantly more users requiring nursing care level 5 and more full-time nursing staff than those not using such terms. Moreover, regarding service provision, the rate of procedures was significantly higher in 11 of 12 items, except for stoma.

Conclusion: The facilities that use terms relating to medical dependency and end-of-life care in their information have more users and provide a greater variety of services. In the future, educational support is required to enable facility managers to understand the services and translate them into their work.

Introduction: We investigated a protocol to support the treatment of constipation that was developed in collaboration with physicians and the effectiveness of Protocol Based Pharmacotherapy Management (PBPM) performed by pharmacists in improving constipation.

Methiod: Patients with constipation who underwent PBPM between August 2020 and May 2021 were included in this study. The results of the Constipation Scoring System (CSS) and the Bristol Stool Form Scale (BSFS) assessments by pharmacists on the first day of intervention and at discharge were collected retrospectively to evaluate the efficacy of PBPM. Wilcoxon's signed rank test was used for statistical analysis, and the threshold value for rejecting the null hypothesis was p < 0.05.

Results: Of the 23 eligible patients, three were excluded according to the criteria, and 20 patients were included. Median CSS improved significantly from 11.5 points [8.25-16.75] at the first intervention to 5.5 points [2.75-10.25] at discharge. The median BSFS improved significantly from Type 2 [2-3] to Type 3.5 [3-4].

Conclusion: PBPM by pharmacists to support the treatment of constipation resulted in improvement of constipation.

The case involved a one-month-old male infant. Around two weeks after birth, cold-like symptoms were observed within the family. Over the course of approximately one month, the infant gradually developed coughing, apnea, and cyanosis, leading to a visit to a nearby medical facility. The episodes of apnea were initiated by a wet-sounding, choking cough. Respiratory pathogen multiplex screening revealed rhinovirus infection. The infant was managed in the intensive care unit and treated with a high-flow nasal cannula (HFNC), which resulted in an improvement of the recurrent episodes of apnea. We discontinued HFNC on the 7th day of hospitalization; however, the patient had recurrence of apnea. After relieving abdominal distension through rectal enema, the infant was successfully weaned off HFNC and discharged on the 14th day of hospitalization. In addition to the immaturity of the respiratory center in infants, laryngeal chemoreflex triggered by chemical receptors in the larynx is known to contribute to apnea. In the present case, we considered that the reduction of respiratory effort through HFNC, the expectorant effect of warmed and humidified air, and the decrease in gastroesophageal reflux due to alleviation of abdominal distension played roles in the successful outcome.

We report an 88-year-old man suffering from repetitive non-occlusive mesenteric ischemia (NOMI) accompanied with bradycardia and portal venous gas. He was admitted to hospital with acute onset epigastralgia and vomiting. Consciousness was clear, but he was pale and had a cold sweat. Vital signs were normal except for sinus bradycardia (HR 42). Abdominal CT revealed portal venous gas. Over 14 months, he had three recurrences of symptoms. We administered a muscarinic antagonist that improved the symptoms at the first and the second recurrence; however, at the third recurrence, the antagonist was ineffective, and the patient had increased portal venous gas, intestinal intramural gas, and hyperlacticacidemia. We performed emergent operation because of the possibility of bowel necrosis. Intraoperative laparoscopy revealed no obvious necrosis, and indocyanine green fluorography revealed no vascular insufficiency. These findings suggested the involvement of NOMI in acute mesenteric ischemia. After surgery, isosorbide dinitrate transdermal patch was administered to prevent NOMI by inhibiting mesenteric artery spasm. A 4-year follow-up revealed no recurrence of NOMI. We report the first case of repetitive NOMI accompanied with bradycardia and portal venous gas and its successful treatment.