Effect of Home-Based Training with a Daily Calendar on Preventing Frailty in Community-Dwelling Older People during the COVID-19 Pandemic.

It has been reported that marked decreases in physical activity including social activities, deterioration in eating habits and mental health, and an increase in frailty have occurred during the COVID-19 pandemic. This study aimed to devise a method to prevent the onset and progression of frailty during the COVID-19 pandemic and to verify its effect. The subjects were 111 community-dwelling older people who answered questionnaires before and after the intervention. A calendar incorporating 31 different tasks, one for each day, was created as an intervention tool with the aim of improving motor, oral, and cognitive functions. The intervention group (n = 49) participants performed these tasks every day for 3 months. The primary outcome was the Kihon checklist (KCL) score. When the amount of change in the KCL score before and after 3 months was compared between the two groups, no difference in the total score was observed between the two groups; however, the intervention group showed significantly improved cognitive function in the KCL sub-domain. In the intervention group, the number of pre-frailty and frailty patients decreased significantly after the intervention compared to before the intervention. These results suggest that the use of the calendar created in this study during the COVID-19 pandemic could prevent decreased cognitive function in the KCL sub-domain and could help prevent the onset and progression of pre-frailty and frailty.

Long-term survival after palliative argon plasma coagulation for intraductal papillary mucinous neoplasm of the bile duct.

Intraductal papillary mucinous neoplasm of the bile duct (IPNB) is an epithelial tumor that can cause obstructive jaundice and cholangitis due to mucin production. Although the effectiveness of argon plasma coagulation in IPNB treatment has been demonstrated, the long-term effect of the therapy is largely unknown. Here, we have presented a patient with IPNB who underwent argon plasma coagulation with a follow-up period of more than 2 years. A 74-year-old woman was referred to our department for treatment of obstructive jaundice. Endoscopic retrograde cholangiopancreatography revealed marked dilation of intrahepatic and extrahepatic bile ducts and thick mucin drainage from the ampulla of Vater. IPNB was diagnosed pathologically from biopsy specimens. Surgery was not recommended because of the extensive intrahepatic spread of the lesion. Endoscopic sphincterotomy, endoscopic papillary large balloon dilation, and insertion of a metallic stent could not resolve the obstructive jaundice. Finally, argon plasma coagulation with percutaneous cholangioscopy was performed 3 times over 1 month. After treatment, obstructive jaundice was resolved and the patient's clinical condition has been stable for more than 2 years, except for a single episode of transient cholangitis. In conclusion, argon plasma coagulation may be an alternative to surgery for the palliation of jaundice with IPNB.