Charcotʼs triad is a well-known clinical feature of acute cholangitis. However, some patients are asymptomatic. We herein report the case of an 84-year-old, female patient with pseudoBartter syndrome on hemodialysis with acute asymptomatic cholangitis, which was detected only through the discovery of yellow discoloration of the dialyzer. Blood testing and imaging studies should be performed for possible, asymptomatic acute cholangitis if a patientʼs dialyzer shows yellowish discoloration.

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Tracheostomy is a common procedure performed in cases of cervical abscess at risk of airway obstruction. However, tracheostomy may increase the risk of descending necrotizing mediastinitis in deep cervical infections extending caudally. We report a case of a deep cervical abscess that was successfully treated using oral tracheal intubation without tracheostomy. A 74- year-old man was referred to our hospital with fever, sore throat, progressive swelling, and pain in the right neck area starting 4 days prior. Contrast-enhanced computed tomography (CT) revealed an abscess with gas production behind the right side of the thyroid cartilage. The right neck was incised, and debridement of the necrotic tissue and drainage of the abscess were performed under general anesthesia. Because the abscess cavity might have extended caudally behind the cricoid cartilage during surgery, the patient was returned to the intensive care unit under oral intubation without tracheostomy：tracheostomy would have increased the risk of descending mediastinitis. The patient recovered well and was discharged 1 month postoperatively. The routine use of tracheostomy is controversial because of the possibility of increased risk of mediastinal contamination due to wound infection from the tracheostomy site.

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[Introduction] The effectiveness of home health care for older patients with heart failure has not been investigated. In the present study, we investigated how home health care after hospital discharge affects the rehospitalization and death of older patients with heart failure. [Methods] The study included patients with heart failure aged 75 years or older who were admitted to an acute-care hospital and subsequently discharged to home. Descriptive statistics were performed for the characteristics on admission and discharge in an intervention group (Group I) and a non-intervention group (Group N). The Group I patients received home nursing and rehabilitation services for 14 days after discharge. [Results] Sixty patients discharged to home were eligible for the analysis. Group I comprised 8 patients and Group N 52 patients. For the total cohort, the median age was 89 years, and 50% were men. The rates of rehospitalization or death within 14 days after discharge were 0% in Group I and 9.6% in Group N. Within 30 days they were 50% and 21.2%, respectively. [Conclusions] Intervention with home health care for 14 days after hospital discharge was associated with a lower rehospitalization rate for patients with heart failure aged 75 years or older.ctive Descriptive Study

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