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Background and Objectives: Muscle cramps are often observed in patients with liver diseases, especially advanced liver fibrosis. The exact prevalence of muscle cramps in outpatients with liver diseases in Japan is unknown. Patients and Methods: This study examined the prevalence of, and therapies for, muscle cramps in outpatients with liver diseases in Tokyo, Japan. A total of 238 outpatients with liver diseases were retrospectively examined. We investigated whether they had muscle cramps using a visual analog scale (VAS) (from 0, none, to 10, strongest), and also investigated their therapies. Results: Muscle cramps were observed in 34 outpatients with liver diseases (14.3%); their mean VAS score was 5.53. A multivariate analysis demonstrated that older age (equal to or older than 66 years) was the only significant factor as-sociated with muscle cramps. The prevalence of muscle cramps among patients with liver diseases seemed not to be higher. The problem was that only 11 (32.4%) of 34 outpatients received therapy for their muscle cramps. Conclusions: Only age is related to muscle cramps, which is rather weak, and it is possible that this common symptom may not be limited to liver disease patients.

Purpose: We conducted surveys in older people at a venue and in home-visits, and compared cognitive and health status between the two groups to assess their cognitive and everyday functioning., Methods: Among 7,614 persons aged 70 years and older living in an urban area, 5,430 responded to a mail survey for sociodemographic characteristics and self-rated questionnaires including the Geriatric Depression Scale-short form (GDS-15). Of these, 1,360 agreed to attend a venue survey, and 693 agreed to take a home-visit survey. Trained nurses examined participants' blood pressure, medical history, and daily functions using the dementia assessment sheet for community-based integrated care system (DASC-21), and tested their cognitive function using the Mini-Mental State Examination (MMSE)., Results: Of 2,053 participants, 2,020 (venue: 1,352; home-visit: 668) completed the MMSE. Median MMSE scores for the venue and home-visit groups were 28 and 26 points, respectively, with 130/1,352 (9.6%) and 205/668 (30.7%) participants below the traditional 23/24 cutoff score. The home-visit group had lower mobility, lower frequency of going out, poorer mental health, and lower independence in instrumental daily activities. Notably, 39.9% and 43.7% of the venue and home-visit groups lived alone, respectively., Conclusions: In this sample of urban older people, the rate of cognitive decline detected using the MMSE was three times higher in the home-visit group than in the venue group. Home-visit participants were more likely to have difficulty in physical, cognitive, and everyday functioning, suggesting they have a greater need for daily living support to continue living in the community., (Copyright © 2021. Published by Elsevier B.V.)

Aim: Although a series of policies have been adapted to deliver an early diagnosis of dementia, many people living with dementia remain undetected and undiagnosed. The aim of this study is to investigate the characteristics of undetected dementia in community-dwelling older people in Metropolitan Tokyo., Methods: We conducted a three-step survey. First, the questionnaires were mailed, in total, to 7614 residents aged ≥70 years in one area in Tokyo, and 5430 were retrieved. Secondly, 2020 individuals attended the face-to-face survey, including Mini-Mental State Exam (MMSE). Thirdly, 198 of 335 individuals who scored <24 on MMSE were visited. Diagnosis of dementia, Clinical Dementia Rating and need for social support were assessed by the interdisciplinary team at their home, and psychological variables, sociological variables and sociodemographic variables were evaluated., Results: Among the 198 participants, 78 (39.4%) were assessed to have dementia. Among those who had dementia, 34 had received a previous diagnosis of dementia in a clinical setting, i.e., the rate of undetected dementia among our 198 participants was 56.4%. People living with dementia without a dementia diagnosis tended to have more complex social support needs, particularly in the domains of dementia diagnosis, medical check-ups for physical conditions, continuous medical care and housing support. In addition, they exhibited signs of frailty., Conclusions: Given that people living with dementia without a dementia diagnosis are at risk of losing housing or physical health, it is a threat to human rights. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2020; ••: ••-••., (© 2020 Japan Geriatrics Society.)

Background: The cost of wasted anesthetic related agents has not been clear in Japanese hospitals. We investigated whether the trainees in anesthesiology influence the cost of wasted anesthetic related agents., Methods: Investigation was carried out at the University of Tokyo Hospital. We interviewed each trainee in anesthesiology about all prepared anesthetic drugs and wasted ones at the end of each anesthetic management., Results: The percentage of wasted ampoules of anesthetic related agents was 15.85%, but the percentage of wasted cost was 5.15%. A large difference was not observed in transition of training period, and this percentage was not improved by training. We considered that this wasted cost is within permissible ranges in comparison with other reports., Conclusions: During the training it is also important to develop a sense of medical economics.

Raw vegetables cut for salad, cooked salad, cooked rice, boiled noodles, bean curd, and cooked Japanese foods were purchased in 27 retail shops in Tokyo. Intact vegetables before being processed and ready-to-eat fresh salad products were obtained from two food factories located in the suburbs of Tokyo. Two hundred thirty-eight retail samples, 137 samples of intact vegetables, and 159 samples of fresh products were examined for aerobic plate count (APC), coliforms, Escherichia coli, Listeria spp., Staphylococcus aureus, and Bacillus cereus. The APC of retail foods were 2.1 to 5.7 log CFU/g, and the range for the coliforms was 0.1 to 2.3 log CFU/g. The APC and coliform values showed that the raw vegetables cut for salad were the most heavily contaminated among the six kinds of ready-to-eat foods examined. Although L. monocytogenes was not detected, two samples of raw vegetables and five kinds of cooked foods yielded Listeria spp. S. aureus was detected in one sample of Japanese cooked food. The APC of the intact vegetables were 2.9 to 7.3 log CFU/g upon arrival and 2.2 to 7.2 log CFU/g after 3 days storage at 10 degrees C. The APC of the fresh products were 3.4 to 7.6 log CFU/g upon arrival and 4.7 to 8.7 log CFU/g after 3 days storage at 10 degrees C. The isolation rates for coliforms were 6.1 to 50% for intact vegetables and 50 to 66.7% for fresh products. E. coli was detected only in the fresh products. B. cereus was isolated from 20.1% (17 of 81) of the intact vegetables and 9.2% (8 of 87) of the fresh products.

Yersinia enterocolitica serogroups O5A and O8 were isolated from fecal samples of one colony of Japanese macaques (Macaca fuscata) from the Tokyo Tama Zoo (Japan). Serogroup O5A was detected in brown bear (Ursus arctos) prior to the isolation from the macaques. Serogroup O5A organisms also were isolated from the Japanese macaques' breeding area. Serogroup O5A and O8 isolates were not pathogenic. Serogroup O8 isolates did not possess the O7 or O19 antigens.