AimTo determine the relationship between multiple medications and falls.MethodsThis case–control and case–crossover study was carried out at Kudanzaka Hospital in Chiyoda, Tokyo, Japan. A total of 325 patients who experienced their first falls when hospitalized between January 2016 and November 2018, and 1285 controls matched by sex, age and clinical departments were included in this study. Hospitalization duration and fall risk score were adjusted for in the analyses.ResultsIn the case–control study, multivariable logistic regression showed that increasing the intake of oral medications was not significantly associated with the incidence of falls (odds ratio 1.02, 95% confidence interval 0.998–1.049). In contrast, drugs prescribed with special caution in accordance with the Elderly Oral Medication Guidelines were significantly associated with falls (odds ratio 1.17, 95% confidence interval 1.09–1.26). A similar pattern was observed in the case–crossover analysis. Among the drugs to be prescribed with special caution according to the guidelines, atypical antipsychotics, non‐benzodiazepine hypnotics and magnesium oxide were significantly associated with the risk of falls.ConclusionThe drugs to be prescribed with special caution according to the guidelines were associated with an increased fall risk. The risk of falls in hospitalized older people due to multiple medications varies among medications. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2021; ••: ••–••.

[This corrects the article DOI: 10.1371/journal.pone.0238723.].

Aims/Introduction: To investigate the impact of increased visceral adiposity with normal weight (OB[-]VA[+]) on the prevalence of non-alcoholic fatty liver disease in patients with type 2 diabetes.Materials and Methods: This was a cross-sectional study of 140 Japanese patients with type 2 diabetes (mean age 65 +/- 11 year; 44.6% women). Visceral fat area (VFA; cm(2)) and liver attenuation index (LAI) were assessed by abdominal computed tomography. The patients were divided into four groups by VFA and body mass index (BMI; kg/m(2)) as follows: BMI <25 kg/m(2) and VFA <100 cm(2) (OB[-]VA[-]), BMI >= 25 kg/m(2) and VFA <100 cm(2) (OB[+]VA[-]), BMI <25 kg/m(2) and VFA >= 100 cm(2) (OB[-] VA[+]), and BMI >= 25 kg/m(2) and VFA >= 100 cm(2) (OB[+]VA[+]). Multivariate linear regression and logistic regression analysis were carried out to determine the impact of OB(-)VA(+) on LAI.Results: In the present study, 25.0% were OB(-)VA(+) patients, where the LAI levels were lower (1.09 +/- 0.22) than those in OB(-)VA(-) patients (1.23 +/- 0.15), and were equivalent to those in OB(+)VA(+) patients (1.03 +/- 0.26). In multivariate linear regression analysis, OB(-)VA(+) was independently associated with LAI (standardized beta-0.212, P = 0.014). In multivariate logistic regression analysis, OB(-)VA(+) was a significant predictor of LAI <0.9 (odds ratio 5.88, 95% confidence interval 1.03-33.52, P = 0.046).Conclusions: The present study provides evidence that increased visceral adiposity with normal weight is a strong predictor for the prevalence of non-alcoholic fatty liver disease in Japanese patients with type 2 diabetes.

We present a case of a 62‐year‐old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi . She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi . Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long‐term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi , followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.

Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis.

Objective Normal-weight abdominal obesity has been reported to be associated with poor mortality. We aimed to investigate the impact of increased visceral adiposity with normal weight (OB(−)VA(+)) on the progression of arterial stiffness in patients with type 2 diabetes. Methods This was a cross-sectional study of 414 patients with type 2 diabetes (mean age 64±12 years; 40.3% female). Visceral fat area (VFA, cm2) was measured by a dual bioelectrical impedance analyzer. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV, cm/s). Patients were divided into four groups by VFA and body mass index (BMI, kg/m2) as the following: BMI<25 kg/m2 and VFA<100 cm2 (obesity (OB)(−)visceral adiposity (VA)(−)), BMI≥25 kg/m2 and VFA<100 cm2 (OB(+)VA(−)), BMI<25 kg/m2 and VFA≥100 cm2 (OB(−)VA(+)), and BMI≥25 kg/m2 and VFA≥100 cm2 (OB(+)VA(+)). Multivariate linear regression analysis was done to determine the impact of OB(−)VA(+) on arterial stiffness. Results Among the patients, 7.2% were OB(−)VA(+) with higher baPWV levels (1956±444 cm/s) than those with OB(+)VA(−) (1671±416 cm/s, p=0.014), those with OB(+)VA(+) (1744±317 cm/s, p=0.048), and those with OB(−)VA(−) (1620±397 cm/s, p=0.024). In multivariate linear regression analysis, OB(−)VA(+) remained independently associated with baPWV (standardized β 0.184, p=0.001). Conclusions This study provides evidence for the burden of arterial stiffness in OB(−)VA(+) patients with type 2 diabetes; therefore, evaluation of visceral adiposity is of clinical relevance for the better management of non-obese individuals as well as obese populations.