Sullivanlowe1958

Following rotavirus vaccination introduction, significant reductions in rotavirus-coded hospitalisation rates were observed in all children aged less then 5 years (up to 79% among non-Aboriginal and up to 66% among Aboriginal). Among adults aged ≥65 years, rotavirus-coded hospitalisations were 89% (95% CI16-187%) higher in the rotavirus vaccination program period. The time series analysis suggested reductions in all-cause gastroenteritis hospitalisations in the post-vaccination period among both vaccinated and unvaccinated (age-ineligible) children, with increases observed in adults aged ≥45 years.ConclusionsRotavirus vaccination has been associated with a significant decline in gastroenteritis hospitalisations among children. selleck The increase in the elderly requires further evaluation, including assessment of the cost-benefits of rotavirus vaccination in this population.Over the last 60 years, many reports have investigated carotid endarterectomy (CEA) and techniques have thus changed and improved. In this paper, we review the recent literature regarding operational maneuvers for CEA and discuss future problems for CEA. Longitudinal skin incision is common, but the transverse incision has been reported to offer minimal invasiveness and better cosmetic effects for CEA. Most surgeons currently use microscopy for dissection of the artery and plaque. Although no monitoring technique during CEA has been proven superior, multiple monitors offer better sensitivity for predicting postoperative neurological deficit. To date, data are lacking regarding whether routine shunt or selective shunt is better. Individual surgeons thus need to select the method with which they are more comfortable. Many surgical techniques have been reported to obtain distal control of the internal carotid artery in patients with high cervical carotid bifurcation or high plaque, and minimally invasive techniques should be considered. Multiple studies have shown that patch angioplasty reduces the risks of stroke and restenosis compared with primary closure, but few surgeons in Japan have been performing patch angioplasty. Most surgeons thus experience only a small volume of CEAs in Japan, so training programs and development of in vivo training models are important.Although it is important for patients with neurofibromatosis type 2 (NF2) to live independently and maintain good quality of life (QOL), no study has examined the social independence status in this patient population. This study aimed to examine the state of social independence and its contributing factors in patients with NF2 using data from a national registry in Japan during the past decade. A database provided by the Ministry of Health, Labour and Welfare of Japan that contained information about all patients with newly submitted claims for medical expense subsidies for NF2 in Japan between fiscal years 2004 and 2013 was analyzed. Individuals aged 6 to 64 years were deemed eligible for the present study. Categories of "employed," "studying," and "housekeeping" were classified as "socially independent." Multivariate logistic regression analysis was performed to examine associations between demographic variables, neurological features, and social independence status. Of 334 participants, 79% were socially independent at the time of registration. Socially dependent participants had more neurological features than those who were socially independent, whereas sex, age, and family history had no significant associations with social independence status. Multivariate logistic regression analysis revealed that participants with bilateral hearing loss, unilateral hearing loss, blindness, hemiplegia, or seizures had significantly higher odd ratios for being socially dependent compared to participants without these features. Our findings, which suggest that these neurological features could restrict social independence, could contribute to the maintenance of better social functioning and QOL in patients with NF2.The present study evaluated the indications for microvascular decompression (MVD) in elderly patients based on the new classification of the elderly population proposed by the joint committee of the Japan Gerontological Society and the Japan Geriatrics Society in 2017.Retrospective analysis of 171 patients with hemifacial spasm (HFS), trigeminal neuralgia (TN), and glossopharyngeal neuralgia (GPN) who underwent MVD in 2018. Patients were divided into three groups based on the proposal old group, 75-89 years; pre-old group, 65-74 years; and not-old group, 64 years or younger. Preoperative comorbidities were divided into five types and the American Society of Anesthesiologists Physical Status (ASA-PS) was recorded. Outcome of the surgery and neurological complications were evaluated in June 2019.No decrease in activity of daily living occurred in any patient and surgical results showed no difference among the three groups. Rate of preoperative cardiovascular diseases was higher in both the pre-old and old groups compared with the not-old group (p less then 0.001 and Cramer V = 0.429). In terms of ASA-PS classification, only ASA-PS I and II were found, and rate of ASA-PS II was higher in the pre-old and old groups compared with the not-old group (p less then 0.001 and Cramer V = 0.407). Some patients suffered from elevated blood pressure after surgery, but were successfully managed.In conclusion, MVD for elderly patients can be achieved safely with careful patient selection and perioperative management. Data should be continuously accumulated for the future development of decision-making algorithm for MVD in the elderly.We report cases of acute subdural hematoma (ASDH) treated by endoscopic hematoma removal with a small craniotomy under local anesthesia. From 2015 to 2019, we retrospectively analyzed 15 ASDH patients who were 70 years or older and met our criteria for endoscopic treatment (1) comorbidities indicated risks associated with a large craniotomy under general anesthesia; (2) decompressive craniectomy was unlikely; and (3) an enlarging hematoma was absent. We also performed a case-control study using the inverse probability weighting method to compare the 15 patients to 20 ASDH patients who were 70 years or older, met criteria (2) and (3), and were treated by craniotomy between 2012 and 2019. Among the 15 ASDH patients, the median age was 86 (range, 70-101) years, and fall was the common cause. The median Glasgow Coma Scale score on admission, operative time, stay time in the operation room, and bleeding amount were 8 (6-15), 91 (48-156) min, 120 (80-205) min, and 20 (5-400) mL, respectively. The extraction rates of all the hematomas exceeded 90%.