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Aim: Since the declaration of an emergency following the spread of COVID-19, the number of elderly patients complaining of delusions has increased. Therefore, we investigated the characteristics of patients diagnosed with delusional disorders in our clinic., Methods: A total of 1,884 patients ≥ 65 years old who visited the Center for Comprehensive Care on Memory Disorders at Kyorin University Hospital from January 2017 to December 2021 were included in the study. The 17 patients diagnosed with delusional disorders were divided into 2 groups based on the timing of the first declaration of emergency, and the characteristics of each group were investigated., Results: Seven patients were diagnosed with delusional disorder before the first declaration of emergency and 10 after the declaration. The proportion of patients increased by approximately three-fold after the declaration. Post-emergency patients were less motivated to be active than those encountered before the declaration, and many had no history of mental illness. Seven of the 10 post-emergency patients visited the Memory Clinic within 1 year of the onset of delusions., Conclusions: After the first declaration of an emergency, elderly patients with no history of psychiatric disorders acutely developed delusional disorders.The physical and psychological effects of COVID-19 on the elderly should be considered.

Aim: With the spread of the new coronavirus infection (COVID-19) and the resulting declaration of a state of emergency, many medical institutions refrained from providing medical care, and patients themselves refrained from visiting hospitals. We also stopped accepting new patients to our outpatient memory loss clinic. We examined whether or not there was any change in the patients who visited our clinic after the state of emergency was lifted., Methods: A total of 517 first-time patients ≥65 years old who visited the Center for Comprehensive Care on Memory Disorders at Kyorin University Hospital from July 2019 to June 2021 were included in the study. Patients were grouped by quarter, and their physical characteristics, frailty, and Comprehensive Geriatric Assessment (CGA) findings were compared., Results: Patients who were first seen in July-September 2020 (Q3) had a higher number of medications and greater proportion of frailty than those who were first-time patients in other periods. Regarding the sub-indices, weight loss (48.6%) and the percentage of those complaining of fatigue (37.5%) were significantly higher in Q3 than in other periods. Regarding the CGA findings, the Vitality Index was significantly lower, and among the sub-items, appetite and motivation for activity were lower in Q3 than in other periods., Conclusions: First-time outpatients at the outpatient memory clinic in Q3 of 2020 had a higher rate of frailty and lower motivation than first-time patients at other times.The spread of COVID-19 infection and behavioral restrictions due to the declaration of a state of emergency may have contributed to the progression of frailty among outpatients with memory loss.

We report two cases of coronary artery spasm during coronary artery bypass surgery. As one of the complications during cardiac surgeries, coronary vasoconstriction occurs mainly after coming off cardiopulmonary bypass. The factors responsible for the spasm include high endogenous catecholamine levels due to inadequate anesthesia and hypothermia, exogenous catecholamines for circulatory support, various chemical mediators and combination of these factors. Coronary artery spasm was suspected strongly because of sudden ischemic change in electrocardiography and simultaneous aggravation of circulatory parameters, which improved immediately after direct injection of coronary vasodilators into vein graft. This method, popular in coronary angiography and catheterization, is effective for release of coronary-artery spasm observed particularly after cardiopulmonary bypass. Then mechanical circulatory assist is readily available to treat possible systemic side effect of the vasodilators.