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Hiromori Sagae, Masato Sugawara, Daiichiro Takahara, Michiaki Takagi, ...Article type: Regular Contribution
2025 Volume 265 Issue 4 Pages 185-191
Published: 2025
Released on J-STAGE: April 11, 2025
Advance online publication: September 12, 2024JOURNAL OPEN ACCESS FULL-TEXT HTMLActivities of daily living (ADLs) with phantom limb pain (PLP) and prosthesis use in patients who underwent lower limb amputation for musculoskeletal malignancies has been reported just by a few researchers. This study aimed to investigate the influence of PLP and prosthesis use on ADLs after lower limb amputation for musculoskeletal malignancies. We conducted a retrospective study on 19 patients (10 males and 9 females) who underwent lower limb amputation for musculoskeletal malignancies between 2003 and 2011 and were followed up until 2021. The mean age was 60.4 (range, 10-85) years. We investigated PLP, prosthesis use, and ADLs after lower limb amputation; we used the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) to assess ADLs. PLP was present in 16 patients (84%), and 4 of 5 survivors (80%) were medication-free at the final follow-up. Prostheses were prescribed in 16 patients (84%), and 11 patients (69%) continued to use the prosthesis after discharge. In a multiple linear regression analysis of ADLs at discharge for the 15 patients with confirmed survival or death, excluding the four patients whose outcome was unknown at the last follow-up, lower-level amputation and good oncologic prognosis were positive independent factors, while age was the only negative independent factor. PLP and prosthesis use did not influence ADLs.
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Takuya Abe, Yumi Watanabe, Kaori Kitamura, Keiko Kabasawa, Toshiko Sai ...Article type: Regular Contribution
2025 Volume 265 Issue 4 Pages 193-200
Published: 2025
Released on J-STAGE: April 11, 2025
Advance online publication: September 05, 2024
JOURNAL OPEN ACCESS FULL-TEXT HTML
Supplementary materialLow blood 25-hydroxyvitamin D (25[OH]D) levels at which C-reactive protein (CRP) levels begin to rise vary. This study investigated the association between blood 25(OH)D and elevated CRP levels and determine the cut-off of low 25(OH)D for elevated CRP in middle-aged and older individuals in the Murakami cohort, Japan. This study used a cross-sectional study design with 2,863 subjects aged 40-74 years living in the community. Plasma 25(OH)D levels were determined with the Liaison® 25OH Vitamin D Total Assay, and serum high sensitivity CRP (hs-CRP) levels were determined with a latex nephelometry assay using an automatic analyzer. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) for high hs-CRP (≥ 3 mg/L) with covariates including sex, age, BMI, physical activity, smoking, drinking, and disease history. Median age of subjects was 65 years, and median 25(OH)D level was 47.4 nmol/L. The proportion of subjects with high hs-CRP levels was 4.1%. The adjusted OR of 25(OH)D < 20 nmol/L was higher (OR = 3.22, 95% CI: 1.42-7.31) than that of the reference (25[OH]D 40-49 nmol/L). In subgroup analysis, the adjusted OR of 25(OH)D < 20 nmol/L was significantly higher than the reference in the BMI ≥ 22.8 (median) group (OR = 4.52) but not in the BMI < 22.8 group (OR = 1.61) (P for interaction = 0.0892), and the adjusted OR was significantly higher in the age ≥ 65 group (OR = 8.51) but not in the age < 65 group (OR = 2.22). Low blood 25(OH)D and high CRP levels were associated, with 25(OH)D 20 nmol/L being the cut-off, which was lower than previously reported values.
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Hidetatsu Tanaka, Kunio Tarasawa, Yu Mori, Kiyohide Fushimi, Kenji Fuj ...Article type: Regular Contribution
2025 Volume 265 Issue 4 Pages 211-219
Published: 2025
Released on J-STAGE: April 18, 2025
Advance online publication: September 12, 2024JOURNAL OPEN ACCESS FULL-TEXT HTMLAn early surgery for older adult patients with hip fractures is recommended to avoid perioperative complications in existing clinical guidelines. Few studies have analyzed only transtrochanteric fractures. The purpose of this study was to assess whether surgery within two days of admission reduces the incidence of pneumonia, deep vein thrombosis, pulmonary embolism, pressure ulcers, and mortality during hospitalization in patients with older adult transtrochanteric femur fractures. In this retrospective study, we used the Japanese National Administrative DPC (Diagnosis Procedure Combination) database that covers April 2016 to March 2022. Transtrochanteric femur fracture was included in patients aged 65 years or older who underwent surgery. The perioperative complications with pneumonia, deep vein thrombosis, pulmonary embolism, pressure ulcers, and mortality during hospitalization were assessed after propensity score matching, focusing on surgeries conducted within two days of admission. After one-to-one propensity score matching for age, sex, and comorbidity, we identified 79,649 pairs of patients who underwent surgery either within two days or after the third day of admission. Surgery delayed beyond two days was independently associated with increased pneumonia, pulmonary embolism, pressure ulcers, and mortality during hospitalization with risk ratios of 1.335 (95% CI: 1.256-1.418, p < 0.0001), 1.287 (95% CI: 1.225-1.351, p < 0.0001), 1.229 (95% CI: 1.094-1.380, p < 0.0001), and 1.063 (95% CI: 0.978-1.155, p = 0.0035), respectively. Surgery within two days of admission for transtrochanteric femur fracture effectively prevents perioperative complications and reduces mortality during hospitalization.
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