Investigation of cryotherapy for pain relief after arthroscopic shoulder surgery.

BACKGROUND: Recently, cryotherapy has become a common practice for postoperative pain management. The current accepted practice in Japan is the use of cryotherapy at 5 °C after arthroscopic shoulder surgery. However, this therapy has been reported to be highly intense because the sustained low temperature causes discomfort for patients. The optimum temperature and duration of cooling required for comfortable and effective cryotherapy after arthroscopic shoulder surgery were investigated. METHODS: Because pain levels might differ depending on the condition, we selected 52 patients with rotator cuff injuries, which were the most common disorders indicated for arthroscopic shoulder surgery. Patients were treated with cryotherapy at 5 °C or 10 °C for 16 h or 24 h. The pain level was determined using the visual analogue scale, and deep shoulder joint temperatures were recorded at different time points for analysis. RESULTS: Pain after arthroscopic shoulder surgery was found to be related to the presence of a brachial plexus block using the interscalene approach during surgical anesthesia. To obtain effective analgesia with cryotherapy, the cooling temperature and duration of cryotherapy had to be changed based on the presence or absence of the brachial plexus block. Patients who received brachial plexus blocks had the lowest recorded pain scores after receiving cryotherapy at 5 °C for 24 h after surgery. Patients who did not receive the block had the lowest recorded pain scores when receiving cryotherapy at either 5 °C for 16 h or 10 °C for 24 h. CONCLUSIONS: Using universal cryotherapy intensity and duration settings regardless of the use of other interventions is likely to unintentionally increase postoperative pain levels. This study revealed that cryotherapy at 5 °C for 24 h was optimal for patients who received an anesthesia block and at 5 °C for 16 h or at 10 °C for 24 h for those who did not receive the anesthesia block. These results can be used as a reference for setting the temperature and duration of cryotherapy after arthroscopic shoulder surgery.

Total Knee Arthroplasty Improved Locomotive Syndrome in Knee Osteoarthritis Patients: A Prospective Cohort Study Focused on Total Clinical Decision Limits Stage 3.

PURPOSE: The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. METHODS: This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. RESULTS: Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. CONCLUSIONS: As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

A questionnaire survey of the illegal importation of pork products by air travelers into Japan from China and exploration of causal factors.

With the aim of obtaining information to establish an import risk assessment on African swine fever (ASF) and other transboundary animal diseases (TADs) into Japan, a questionnaire survey was conducted between 1 August and 20 September 2019 on air travellers arriving into Japan from China. There were 248 responses with 2.8 % of respondents illegally importing pork products. The quantity imported per traveller varied between 250 g and 2 kg. Concerning the travellers' perception in regard to the difficulty of importing a pork product in their luggage, 32 respondents (12.9 %) considered it very easy or rather easy and 216 (87.1 %) very difficult or rather difficult. In regard to the recognition of respondents of the illegality of importing pork products into Japan, seven respondents (2.8 %) did not consider this practice to be illegal whilst 241 (97.2 %) had some idea of the illegal nature of this behaviour. The regression analysis revealed that the practice of illegal importation of pork products was significantly affected by the level of difficulty perception held by the traveller (P < 0.001) and that the difficulty perception is significantly affected by the level of recognition of illegality by the traveller (P < 0.001). The result of this study will not only provide useful data in developing a model to assess the probability of introduction of ASF and other TADs into Japan and other countries, but also in monitoring the effect of measures taken by the government to reduce the illegal importation of meat and meat products.

Treatment of larva migrans syndrome with long-term administration of albendazole.

BACKGROUND: Larva migrans syndrome is a food-borne parasitic disease in humans, caused by accidental ingestion of eggs or larvae of ascarid nematodes, namely, Toxocara canis, Toxocara cati, or Ascaris suum, the roundworms commonly found in the intestines of dogs, cats and pigs respectively. When a patient is diagnosed as having larva migrans syndrome, oral-administration of albendazole is recommended, however, the regimen remains controversial worldwide. In Japan, the duration of albendazole administration is longer than those of European and North American countries. The purpose of this study was to assess the efficacy and safety of long-term administration treatment of albendazole for larva migrans syndrome. METHODS: From 2004 to 2014, our laboratory was involved in the diagnosis of 758 larva migrans syndrome cases, of which 299 cases could be followed up after the treatment. We analyzed these 299 follow-up cases on the ELISA results before and after the treatment as well as on anthelmintic used, dose and duration of medication, clinical findings, and side effects, recorded on a consultation sheet provided by the attending physicians. We have 288 cases as the subjects of this study. RESULTS: Albendazole represented a 78.0% efficacy rate. The side effects represented 15.0% in using albendazole alone cases; however, the side effects were mild to moderate and there were no severe cases reported. CONCLUSIONS: The long-term administration treatment of albendazole is safe and effective for larva migrans syndrome.

Relationship between social capital and happiness in a Japanese community: A cross-sectional study.

The influence of social capital on happiness is attracting attention around the world. Many studies that investigated the relationship between social capital and happiness suggest that happiness correlates to a positive social environment. The aim of this study was to examine the relationship between social capital and happiness in a community with the lowest National Health Insurance expenditures in Miyazaki Prefecture (Japan). This cross-sectional study targeted 2730 residents in the community aged 40-75 years who were covered by National Health Insurance in 2015. A self-administered questionnaire consisting of questions focusing on demographic characteristics, happiness, and social capital was sent to the residents, and 1106 of them (40.5%) returned the questionnaires by the deadline. The analysis of responses indicated a positive relationship between social capital and happiness with regard to all three factors of social capital (trust, connections and interaction, and social participation). Evaluating the relationship between social capital and health in terms of happiness is important to creating a lively society in which citizens support one another, in addition to promoting physical and mental well-being.

Paragonimiasis in Japan: a twelve-year retrospective case review (2001-2012).

OBJECTIVE: Paragonimiasis, or lung fluke infection, is a food-borne parasitic disease caused by infection with trematodes belonging to the genus Paragonimus. Although paragonimiasis was once considered successfully controlled in the 1970s, new cases began to emerge in the late 1980s. To apprehend the current-day situation of the re-emergent cases of paragonimiasis in Japan, we conducted a retrospective review of 443 patients who were referred to our laboratory and diagnosed as having paragonimiasis during 2001-2012. METHODS: Patients were diagnosed as having paragonimiasis based primarily on immunodiagnostic methods in addition to clinical, laboratory, and radiographic findings. Patient data were extracted from consultation sheets from attending physicians and were analyzed. RESULTS: Majority of the patients were residents of Kyushu Island. However, a substantial number of cases were also from other parts of Japan. Immigrants (mostly from China, Thailand, and Korea) accounted for a quarter of the cases. Native Japanese contracted paragonimiasis by consuming wild boar meat or freshwater crabs, whereas immigrants contracted the infection almost exclusively by consumption of freshwater crabs. Eosinophilia and elevated serum IgE levels were found in around 80% of the patients. Parasite egg detection was documented only in 11.7% of the cases, showing the reliance on serological tests for diagnosing paragonimiasis in current clinical practice. CONCLUSION: Paragonimiasis remains a public health issue in Japan, and the situation should be closely monitored.