Introduction: The purpose of this study was to identify factors affecting the length of hospitalization of elderly patients with urinary tract infection (UTI) in an acute care hospital, where general practitioners treat the majority of them.
Methods: Subjects were patients aged ≥ 65 years with UTI who were admitted to our hospital between April 2019 and March 2021. The primary endpoint was the length of hospital stay on an acute care ward. Factors associated with the primary endpoint were detected using logistic regression analysis with several explanatory variables (patients' baseline characteristics, laboratory findings, and interventions during hospitalization).
Results: In total, 143 cases were eligible for analysis (88±7 years old, 37% male). Multivariate logistic regression analysis revealed that: Charlson Comorbidity Index ≥ 6, complex UTI with urologist's assessment, and the score of the Functional Oral Intake Scale (FOIS) on admission were significant factors correlated with the length of hospitalization (odds ratios: 5.07, 0.13, and 0.30, respectively).
Conclusion: In older patients with UTI, CCI≥6, UTI without urologist's assessment, and a lower score of FOIS may prolong the length of stay in an acute care hospital.
Introduction: The purpose of this study was to clarify factors related to recognition of the possibility of end-of-life care at home (hereafter referred to as end-of-life care) among middle-aged and elderly people living in heavy snowfall and depopulated areas.
Methods: Residents aged 40~69 years in town B, prefecture A were surveyed by mail using a self-administered, unmarked questionnaire. Analysis methods were: (1) a reliability analysis of survey items, (2) basic statistics, (3) tests for differences in composition ratios, (4) tests of differences between the two groups for each item, and (5) binomial logistic regression analysis. Recognition of the possibility of end-of-life care was used as the objective variable, and sex, age, and 18 indicators significant in (3) and (4) were used as explanatory variables.
Results: There were 63 in the positive group for end-of-life care, 239 in the negative group, and 120 in the unknown group (Response rate: 44.1%). Factors related to perception of the possibility of end-of-life care were positively related to "existence of a community hospital, " "positive image of end-of-life care, " and "trust in people in the community. "
Conclusion: In depopulated areas, it is necessary to consider specific measures to promote the three factors that raise awareness of the possibility of end-of-life care.
A woman in her 50s presented to the hospital with a chief complaint of headache and nausea. Graves' disease was diagnosed based on positive blood test results for thyrotoxicosis and TSH receptor antibody and ultrasonographic thyroid gland findings. The patient was hospitalized and started treatment with thiamazole; however, after hospitalization, psychiatric symptoms, such as visual and auditory hallucinations, appeared, and she fulfilled the diagnostic criteria for thyroid crisis. We increased the dose of thiamazole and added potassium iodide. Thyroid function improved; however, the patient experienced reemergence of psychiatric symptoms. Blood tests revealed pseudohyperchloremia, which led to the discovery of abuse of over-the-counter analgesics containing bromwarelyl urea. The psychiatric symptoms were suspected to be due to withdrawal from chronic bromine intoxication. After starting psychotropic drugs, the patient's psychiatric symptoms became mild, her thyroid function continued to improve steadily, and she was discharged from the hospital. Thyroid crisis is a condition that should be suspected and treated at an early stage; however, the diagnostic criteria for thyroid crisis can be false-positive if the thyroid disease is accompanied by other conditions that cause psychiatric symptoms.
A certain period of time has passed since the transition to the General Medicine residency system under the Japanese Medical Specialty Board and Family Medicine specialist training system by the Japan Primary Care Association. We have summarized the needs of residents identified in the survey, and detailed the activities to date and prospects of the Japanese Association of Family Physician Trainees, a self-help support organization, which is an official subcommittee of the Japan Primary Care Association, from the viewpoint of the residents. We believe that this paper will serve as a resource for the training of residents, help guide them under the new system, and help to improve the training system, considering evidence suggesting that information may not be reaching residents who need support.
In Japan, there are insufficient measures to ensure that women can maintain good health while working. In addition, many women have limited health literacy, making it difficult for them to access information on physical and mental health problems that are specific to them. In this context, it is essential for pharmacists to become the first point of contact for women seeking information about their physical health, as they are familiar with healthcare providers in the community. To address this issue, we organized a Women's Health Care Cafe for pharmacy students to provide them with an opportunity to learn about women's health.