Among the patients admitted to our hospital, some who wear diapers experience superficial fungal infections （fungal disease）. However, the factors associated with the development of fungal diseases among inpatients are, as of yet, unknown. The present, retrospective study aimed to identify the risk factors of fungal disease development. One hundred eleven patients with a fungal disease who were admitted to the study center between January 2016 and December 2017 were included. The control group comprised 303 patients without a fungal disease who were housed in the same room as the patients or in an adjoining room. The variables of interest were age, sex, medical department, diabetes status, malignancy, an infectious disease such as pneumonia, antibiotic use, incontinence, stool properties, and diaper use.
　Multivariate analysis identified five risk factors of fungal infection: diaper use（odds ratio［OR］: 5.97; 95% confidence interval［CI］: 3.15-11.30; p < 0.001）, diarrhea（OR: 8.51; 95% CI: 2.8-25.02; p < 0.001）, tube feeding（OR: 2.90;95% CI: 1.71-4.90; p < 0.001）, antibiotic use（OR: 5.35; 95% CI: 2.86-10.02; p < 0.001）, and preexisting infection（OR: 2.01; 95% CI: 1.08-3.76; p < 0.03）.
　The risk of fungal infection was found to be high among inpatients who wore diapers, had diarrhea, received tube feeding, took antibiotics, and had a preexisting infection.

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　The present, prospective, longitudinal study aimed to examine the characteristics of skin tears, their development, and treatment outcomes by following 96 elderly patients with skin tears at 25 hospitals in Hokkaido with wound, ostomy, and continence nurses. The period from skin tear occurrence to healing or discharge was examined in each patient, and the rate of skin tear occurrence, patients' experience of the skin tears（e.g., pain, Quality of Life score［QOL］, etc.）, treatment outcomes（treatment period and cost）, and treatment method were analyzed.
　Of the 96 patients, most（average age: 81.3±11.9）had skin tears on the arms（83.1%）. Skin Tear Classification System（STAR）category 2b was most common at 49.0% of the cases. Pain caused by the tears was rated using the Numeric Rating Scale, which yielded a score of 1.9±2.1 indicating lower sensitivity in elderly than in younger patients. The average utility value based on Euro-QOL-5D-5L at the time of tear occurrence was .42±.23, which was similar to that of other wounds. The average healing period was 12.0±6.2 days, and the average medical cost for treatment was ￥3,052±3,240, demonstrating that the cost increased with increasing wound area（p< .05）. The wound area reduction rate per day was calculated after correcting for baseline differences. STAR category 1b was significantly more common than 2b（p< .05）; 1b tears had better engraftment because they involved using a flap which more effectively covered the wound when returned to its normal position.

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　Calluses are defined as “hyperkeratosis caused by excessive mechanical loading in particular areas” and can contribute to the development of diabetic foot ulcers（DFUs）. Callus inflammation is a premonitory symptom of DFUs. To prevent DFUs, recent studies have recommended thermographic monitoring of foot skin temperature, which is recognized as a sign of skin inflammation. However, no studies have examined whether elevated foot callus temperature indicates callus inflammation. The purpose of this study was to examine whether elevated skin surface temperature of the foot callus is associated with inflammatory marker in people with diabetes. This crosssectional study included 30 individuals with diabetes who had a foot callus. Callus inflammation was identified by skin blotting for tumor necrosis factor- α（TNFα）. The association between elevated skin surface temperature, measured by thermography, and callus inflammation was analyzed using Fisher’s exact test. This study was approved by the Research Ethics Committee of the Graduate School of Medicine, The University of Tokyo. TNF αpositivity was significantly associated with elevated skin temperature of the callus（p = 0.009）. The sensitivity, specificity, positive predictive value, and negative predictive value of increased temperature for predicting callus inflammation were 0.67, 0.83, 0.73, and 0.79, respectively. Our findings suggest that thermal elevation at the callus indicates the callus inflammation, and screening for elevated skin temperature of the callus using thermography may contributes to early intervention to prevent its progression to DFU.

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Background
　In patients with breast cancer, the management of edema focuses on lymphedema that occur after lymph node dissection of the upper limbs, which also have care guidelines. However, docetaxel-related edema affects not only the upper limbs but also the lower limbs, and current management is inadequate. We aimed to clarify the detailed characteristics of lower limb edema due to docetaxel in patients with breast cancer.
Methods
　Participants were patients with breast cancer who underwent chemotherapy with docetaxel within 5 years. Patients with cardiac and hepatic dysfunction and deep vein thrombosis were excluded. The incidence, time, duration, site, management, education, and risk factors were investigated using questionnaires and medical records.
Results
　Lower limb edema was observed in 13/43 participants（30.2%）. Lower limb edema most frequently appeared after the fourth administration of docetaxel（46.2%）. The duration ranged from a few days to 5 months. The site of edema was usually the anterior part of the lower legs and the dorsal surface of the feet in 12（92.3%）participants. Regarding management, three participants underwent lymphatic drainage. Only five participants had been educated about the onset of edema. Stage IV breast cancer was a risk factor associated with the onset of lower limb edema.
Conclusion
　Stage IV breast cancer was found to be associated with lower limb edema in patients treated with docetaxel. Especially for Stage IV patients, management should be started once docetaxel administration is initiated. The site of management is recommended to be from the lower leg to the dorsum, and should last for > 1 month.

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