This article presents the case of a boy diagnosed with both obsessive–compulsive disorder (OCD) and autism spectrum disorder. Long-term hospitalization was required to improve the patient's OCD symptoms and family relationship. In his last year of compulsory schooling, a multidisciplinary team, led by a nurse, took various approaches to help him self-determine his pathway. In their role of assisting the patient with daily living, the nurses were at risk of becoming involved in his compulsive behavior and developing negative feelings. To support his self-determination, having a mutually supportive environment was essential between the multidisciplinary team and team members, which included discussing his daily living concerns and venting out negative feelings. In this case, ongoing dialog with the medical staff was important for the individual and parents to move forward positively within a supportive framework.

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness, impaired psychosomatic functioning, and a reduced quality of life. We identified several factors influencing life satisfaction and suggested ways to improve it in patients with narcolepsy. To the best of our knowledge, this is the first study to measure life satisfaction in patients with narcolepsy and to examine the interdependence of various factors related to life satisfaction using path analysis. A questionnaire was administered to 87 individuals diagnosed with narcolepsy. A hypothetical model was tested to determine its effect on life satisfaction. The results of the path analysis were χ² = 11.94 (p = 0.53), GFI = 0.96, AGFI = 0.92, CFI = 1.00, and RMSEA = 0.00. The overall effects were impact on activities (β = 0.41), self-acceptance (β= 0.36), adaptive attitude (β = 0.36), excessive daytime sleepiness (β = 0.13), mental disorder (β = 0.10) and attention-deficit/hyperactivity disorder (β = 0.08). The results indicate that medical conditions such as sleepiness do not impair life satisfaction. This study suggests that life satisfaction can be increased through self-understanding and engaging in adaptive cognition.

Diabetic foot ulcers (DFUs) pose a significant health challenge, marked by high morbidity, mortality, and healthcare costs. Effective evaluation of the DFU healing process is crucial to prevent delays and enhance patient outcomes. Traditional wound healing scales like PUSH and DESIGN have proven suboptimal for DFUs, necessitating a disease-specific approach. This communication introduces a qualitative study, which served as the first step in developing the DMIST scale, a tool to monitor and assess DFUs over time. Using a morpho-qualitative analysis method, we examined 50 DFUs in 42 patients from a hospital in Tokyo, classifying ulcers by primary pathogenic factors and healing periods. Our analysis identified 8 categories and 33 sub-categories of morphological characteristics. Key findings included identification of features such as the "red ring", "hyperkeratosis", and "rolled wound edges", each affecting healing times. The DMIST scale integrates these visual signs, offering a practical tool for DFU management, particularly valuable in low-resource settings. This scale has undergone validation and refinement through international collaboration, with the aim to improve DFU patient outcomes globally. We hope the DMIST scale to be widely adapted and that our experience in its development will aid future development of wound assessment tools from various causes.

In connective tissue diseases, eosinophil is thought to varying extents to be involved in the pathogenesis. Increased eosinophils in the skin tissues of patients with dermatomyositis (DM) have been reported, but there have been no investigations of blood eosinophilia in patients with DM. This study is the aim of determining the frequency of peripheral blood eosinophilia and elucidating its clinical significance. We retrospectively collected the clinical records of 48 patients (15 men and 35 women) who were diagnosed with classical DM (n = 34), ADM (n = 13), and JDM (n = 1), on the basis of the 2017 EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies. Eosinophil count ≥ 400/mm³ was observed in 14.6% (n = 7) of the patients, while 4.2% (n = 2) of patients had eosinophil counts >1,000/mm³. Regarding the clinical significance of peripheral blood eosinophilia in DM patients, in seven patients with increased blood eosinophil counts, the prevalence of Gottron's sign/papules, heliotrope rash, V-neck sign, shawl sign, pruritus, internal malignancy, and positive anti-TIF1-γantibody were more frequent than in those without (85.7% , 85.7%, 71.4%, 71.4%, 85.7%, 42.9%, 28.6% vs. 92.7% p = 0.48, 61.0% p = 0.40, 36.6% p = 0.11, 39.0% p = 0.22, 36.6% p = 0.034, 19.5% p = 0.33, and 19.5% p = 0.63, respectively). Among them, pruritus was more common in patients with elevated eosinophil counts with statistical significance. The activity of eosinophilia and severity of skin eruptions also tended to be correlated. In summary, our study suggests that blood eosinophilia is correlated with the presence of pruritus, but not disease-associated autoantibodies or internal malignancy.