Nihon rinsho. Japanese journal of clinical medicine
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Frailty is a predictor of functional decline, falls, hospitalization, and mortality. Fried et al. developed the frailty index, which include 5 simple items: weight loss, weakness, exhaustion, slowness, and low activity. ⋯ Both frailty and sarcopenia could be associated with mild cognitive impairment which leads to dementia. Thus, early initiation of a comprehensive geriatric health examination and a multidomain intervention such as diet, exercise, cognitive training, and vascular risk monitoring may be useful to prevent frailty and sarcopenia in community-dwelling older adults.
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Several promising tau imaging probes have been developed by Tohoku University ([18F]THK series), National Institute of Radiological Sciences([11C]PBB3), Eli Lilly ([18F]T807), and Hoffman-La Roche ([18F]R06958948). In this paper we discussed some of the criteria required for the tau imaging probe in Alzheimer's disease. It will be certain that tau imaging plays an important role in an accurate diagnosis and as companion diagnostics.
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It is necessary to treat the patient from the site of the emergency to raise a lifesaving rate of the patient. As a prime example would be out-of-hospital cardiac arrest. Once you start the treatment after hospital arrival, cardiac arrest patient can't be life-saving. ⋯ It is because of that the quantity and quality of the emergency life-saving technician are being enhanced. And also doctor-helicopter system have been enhanced. Medical control is a critical component of the improvement.
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A role of acute hospitals providing emergency care is becoming important more and more in regional comprehensive care system led by the Ministry of Health, Labour and Welfare. Given few number of emergent care specialists in Japan, generalists specializing in both general internal medicine and family practice need to take part in the emergency care. In the way collaboration with specialists and regional primary care physicians is a key role in improving the quality of emergency care at acute hospitals. A pattern of collaborating function by generalists taking part in emergency care is categorized into four types.
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Fifteen years have passed since lung protective strategy to the patients with acute respiratory distress syndrome (ARDS) established. Recently, the new Berlin Definition of ARDS has been developed and this classified ARDS into three stages (mild, moderate, and severe ARDS), depending on the PaO2/FiO2. After this new definition of ARDS, each treatment to the patients with ARDS should be considered, depending on the severity of lung injury, such as prone position to the patients with severe ARDS, muscle paralysis to the patients with severe ARDS. In this review article, we review the history of lung protective strategy and ARDS definition, discuss the novel physiological approaches to minimizing ventilator-induced lung injury, and highlight a numbers of experimental/clinical studies to support these concepts.