Maintaining Weight and Nutritional Status with Ninjin'yoeito in Elderly Patients with Chronic Wasting Diseases.

Objectives: This retrospective study aimed to obtain information on the nutritional maintenance effects of Ninjin'yoeito (NYT) in elderly patients with chronic wasting diseases.

Methods: Changes in body weight and serum levels of total protein and albumin were investigated in patients who received NYT for chronic wasting diseases for more than six months in Mito Medical Centre, University of Tsukuba-Mito Kyodo General Hospital, Mito, Japan, from April 2009 to October 2019.

Results: During the study period, 11 patients (median age: 75 years) received NYT for six months or more.

Rinsing of oropharynx and storage place of respiratory medicine inhaler: A cross-sectional audit.

Background: In patients with bronchial asthma and those with chronic obstructive pulmonary disease (COPD), inhalation therapy and rinsing of the mouth and the oropharynx by gargling ("RMOG") after inhalation are recommended. We performed a cross-sectional audit aimed at investigating (a) the proportion of patients performing "RMOG" after inhalation and (b) storage place of patients' inhaler.

Methods: Patients with bronchial asthma and those with COPD were asked by medical aids at outpatient visits whether they did "RMOG every time," "RMOG sometimes," or "no RMOG" after inhalation, and where they stored their inhaler.

Awareness of Diagnostic Error among Japanese Residents: a Nationwide Study.

Background: Residents' understanding of diagnostic error may differ between countries. We sought to explore the relationship between diagnostic error knowledge and self-study, clinical knowledge, and experience.

Methods: Our nationwide study involved postgraduate year 1 and 2 (PGY-1 and -2) Japanese residents.

Can Total Body Resistance Measured Using Bioelectrical Impedance Analysis Be the Index of Dehydration in Older Japanese Patients?

Background: Dehydration in older patients has long been considered a significant health problem because it implies increased morbidity and mortality. However, dehydration is detected by a combination of physical signs and blood tests. For older people dwelling at home and in nursing homes, a simple and non-invasive method for detecting dehydration by caregivers is needed.

Impact of inpatient caseload, emergency department duties, and online learning resource on General Medicine In-Training Examination scores in Japan.

Background: Both clinical workload and access to learning resource are important components of educational environment and may have effects on clinical knowledge of residents.

Methods: We conducted a survey with a clinical knowledge evaluation involving postgraduate year (PGY)-1 and -2 resident physicians at teaching hospitals offering 2-year postgraduate training programs required for residents in Japan, using the General Medicine In-Training Examination (GM-ITE). An individual-level analysis was conducted to examine the impact of the number of assigned patients and emergency department (ED) duty on the residents' GM-ITE scores by fitting a multivariable generalized estimating equations.

Wernicke encephalopathy and pellagra in an alcoholic and malnourished patient.

Deficiency of multiple vitamins can be identified in alcoholic and malnourished patients. We report a patient with Wernicke encephalopathy, a B1 deficiency and pellagra, a niacin deficiency. A 61-year-old Japanese man presented with generalised weakness.

Challenging cases of professionalism in Japan: improvement in understanding of professional behaviors among Japanese residents between 2005 and 2013.

Background: Professionalism is deemed as the basis of physicians' contract with society in Japan. Our study in 2005, using a questionnaire with scenarios to professionalism, suggested that many physicians at various levels of training in Japan encounter challenges when responding to these common scenarios related to professionalism. It is unclear how medical professionalism has changed among Japanese residents in over time.

Occam's Razor or Hickam's dictum: a paraneoplastic or coincidental occurrence of lung cancer and Guillain-Barré syndrome.

A 67-year-old man was admitted due to weakness, coughing, shortness of breath and fever. He had decreased breath sounds in the left lung and muscle weakness in the lower and upper extremities. Chest imaging showed a mass in the left lung, and a biopsy revealed small cell lung cancer.

Clarithromycin-induced haemorrhagic colitis.

Haemorrhagic colitis by Klebsiella oxytoca has been described as an antibiotic-associated colitis, particularly with the use of ampicillin. Here we report a patient with haemorrhagic colitis caused by K oxytoca after the use of clarithromycin. A 67-year-old Japanese woman with diabetes presented with mucobloody diarrhoea and abdominal pain.

The measurement of axillary moisture for the assessment of dehydration among older patients: a pilot study.

Purpose: Dry axilla can sometimes be found among dehydrated older patients. In this study, we measured the axillary moisture and assessed it as possible marker for dehydration.

Methods: Twenty-nine older patients admitted with acute medical conditions participated in this study.

Physical signs of dehydration in the elderly.

Objective: Dehydration is a common condition and frequent cause of hospitalization in older people, despite the caregiver's high attention in attempt to avoid its occurrence. In this study, various physical signs were examined as clinical signs of dehydration in elderly.

Methods: A prospective observational study was conducted in an acute care teaching hospital.

Diphyllobothrium nihonkaiense infection linked to chilled salmon consumption.

This is a case of a 40-year-old Japanese adult male who had acute onset watery diarrhoea with intermittent abdominal discomfort. Several days later, he found a 1 metre of tape-shaped object emerged from his anus and was eventually admitted to our hospital for further investigation. Stool examination revealed eggs of Diphyllobothrium with characteristic shape in his stool.