Cross-sectional survey of depressive symptoms and suicide-related ideation at a Japanese national university during the COVID-19 stay-home order

BACKGROUND@#We aimed to estimate the prevalence of depressive symptoms as well as suicide-related ideation among Japanese university students during the stay-home order necessitated by the coronavirus disease 2019 pandemic in Japan, and offer evidence in support of future intervention to depression and suicide prevention strategies among college and university students.@*METHODS@#The data for this cross-sectional study were derived from the Student Mental Health Survey conducted from May 20 to June 16, 2020 at a national university in Akita prefecture. Among the 5111 students recruited, 2712 participated in this study (response rate, 53%; mean age ± standard deviation, 20.5 ±3.5 years; men, 53.8%). Depressive symptoms were identified by using the Patient Health Questionnaire-9 (PHQ-9).@*RESULTS@#The prevalence of moderate depressive symptoms based on a PHQ-9 score ≥10 and suicide-related ideation based on question 9 of PHQ-9 ≥1, which encompasses thoughts of both suicide and self-harm, was 11.7% and 6.7%, respectively. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both depressive symptoms and suicide-related ideation.@*CONCLUSIONS@#Negative lifestyles of smoking and drinking, and being a woman, may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be protective factors.

Surgical Repair in Case of an Elderly Tetralogy of Fallot / 日本心臓血管外科学会雑誌

A 62-year-old woman with the tetralogy of Fallot (TOF) diagnosed at 24 years of age, was admitted with fever and dyspnea. She also had cyanosis and heart failure and was categorized as New York Heart Association (NYHA) functional class IV. Echocardiography showed TOF with a-grade III tricuspid valve regurgitation. Cardiac catheterization revealed major aorto-pulmonary collateral arteries (MAPCAs) for the left upper pulmonary circulation. After coil embolization of MAPCAs to reduce abnormal intracardiac return as well as postoperative left ventricular volume overload, the patient underwent total surgical correction (i.e., right ventricular outflow tract reconstruction using Medtronic FreeStyle Valve and transannular patch, ventricular septal defect closure, and tricuspid annuloplasty). Postoperatively, the patient had a satisfactory course during the 10-year follow-up period with a grade-I NYHA classification. In conclusion, intracardiac repair of TOF in case over 60 years of age can be performed safely by preoperative MAPCAs embolization and subsequent TOF repair with a strategy to abolish pulmonary and tricuspid valve regurgitation.

Subpectoral Technique of Pacemaker Implantation\\-Reduction of Cost and Length of Hospital Stay- / Journal of Rural Medicine

Objective: To reduce the length of hospital stay for patients undergoing pacemaker surgery. Patient and Methods: We prevented the leads from dislodging by anchoring a screw-in type pacing lead in the right atrium/ventricle through a cephalic vein that was cut down. We retrospectively compared the cost and duration of the hospital stay for the subpectoral technique (35 cases; January 2005-March 2006) and conventional technique (subcutaneous pocket and subclavian vein puncture) (18 cases; October 2003-December 2004) groups. Results: The mean (± SD) duration of hospital stay was 5.1 ± 2.1 days for the subpectoral technique group and 22.2 ± 15.2 days for the conventional technique group (P < 0.001), and the cost was 2,167,883 ± 147,549 yen in the subpectoral technique group and 2,528,053 ± 217,810 yen in the conventional technique group (P < 0.001). We noted no major complications such as bleeding, lead dislodgement, or wound infection. Conclusion: Our novel subpectoral technique helped reduce the length and cost of the hospital stay associated with pacemaker surgery.

CT and MRI diagnosis of acute traumatic hepatic rupture: analysis of ten cases / 中华创伤杂志(英文版)

OBJECTIVE: In order to verify whether magnetic resonance imaging (MRI) is superior to computed tomography (CT) in the detection and characterization of intrahepatic hematoma in its acute stage, the MRI and CT features of acute traumatic hepatic rupture (ATHR) were retrospectively studied and compared. METHODS: In the 10 cases of ATHR admitted to our institute, 3 were examined with CT, 1 with MRI and 6 with both CT and MRI in the first 24 hours post injury and 9 cases out of the 10 were checked up with MRI in the first week after injury of surgery. The shape of the traumatic lesions, the damages of the intrahepatic vessels and the severity of hepatic rupture displayed with CT and MRI were compared. RESULTS: It was found that in the first 24 hours post injury, 66.6% of hepatic injuries were shown as hypointensity on T1-weighted images and low or high density on noncontrast CT. 100% of the lesions were identified as well-marked hyperintensity on T2-weighted images. Damages of the hepatic and/or portal veins were observed in 7, 4 and 3 cases on T2- and T1-weighted images and noncontrast CT figures respectively. The severity of hepatic injuries were graded in 100%, 66.7% and 44.4%of cases with these 3 procedures respectively. CONCLUSIONS: On the basis of our findings, it is concluded that T2-weighted MRI is a more sensitive and reliable imaging modality in the detection and differentiation of the type and severity of acute hepatic rupture than T1-weighted imaging and noncontrast CT.