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Backgrounds While there is a concern about the increase in the occurrence of acute aortic dissection caused by the worsening of hypertension, mental stress, etc., there is a lack of data regarding the influence of disasters on this event. The aim of this study was to address this issue in the acute-subacute phase after the Kumamoto Earthquake occurred on April 14 2016. Methods We retrospectively investigated the impacts of the Kumamoto Earthquake on various cardiovascular diseases, including acute aortic dissection, utilizing the medical records of patients in 16 hospitals in Kumamoto Prefecture during the period from April 14 to June 30 (78 days) in 2014, 2015, 2016, and 2017. Results The occurrence of heart failure and venous thromboembolism increased significantly in the acute-subacute phase after the earthquake. When comparing the earthquake year (2016) to the non-earthquake years (2014, 2015 and 2017), the difference in the occurrences and mortalities of acute aortic dissections were not significant. When other characteristics of the patients were compared between the earthquake year and the non-earthquake years, there were no differences. Conclusions It might be possible that the Kumamoto Earthquake did not affect the incidence of acute aortic dissection or deaths from acute aortic dissection, possibly because the climate was mild and the preventive efforts based on previous experience were successful.

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Immune checkpoint inhibitors can affect any organ, including the salivary glands. A case of Sjögren's syndrome (SjS) induced by nivolumab for the treatment of gastric cancer is herein presented. Nivolumab treatment caused marked tumor shrinkage, but xerostomia developed after two cycles. It took 3 months after symptom onset to confirm the diagnosis of SjS. Prednisolone and pilocarpine hydrochloride did not relieve the symptoms. SjS is a relatively rare immune-related adverse event that might sometimes be overlooked. Since SjS can severely impair a patient's quality of life, oncologists should not miss any signs of salivary gland hypofunction and cooperate with specialists for SjS.

Purpose of Review Natural disasters occur frequently in Japan. A disaster medical system was rapidly developed in Japan following the Great Hanshin-Awaji Earthquake in 1995. Dentistry has become increasingly important in disaster medicine. This review summarizes the roles of dental professionals in disaster medicine, highlights relevant issues, and identifies new directions for research to improve disaster relief activities based on our previous experiences as dental professionals supporting the victims of major disasters. Recent Findings Many preventable deaths after a disaster are caused by aspiration pneumonia, which occurs against a background of factors that are compounded by a harsh living environment. An important aim of dental care in disaster medicine is to prevent these disaster-related deaths in vulnerable persons such as the elderly. This can be achieved through interventions to maintain oral hygiene, preserve and enhance oral function (i.e., chewing and swallowing), and improve the diet, since these interventions help to prevent the development of malnutrition and frailty in vulnerable people. Dental identification of disaster victims could be improved through the use of intraoral three-dimensional scanners and artificial intelligence to automate the acquisition of dental findings and through the construction of a national database of digitized dental records. Advances in personal identification methods will be needed given the prediction that a catastrophic earthquake will occur on the Nankai Trough during the next 30 years and claim more victims than the 2011 Great East Japan Earthquake. Summary Disaster-related deaths due to aspiration pneumonia can be prevented by providing appropriate dental care to those in need. The process of identifying victims could be made more efficient through the use of intraoral three-dimensional scanning, artificial intelligence, and a digital database of dental records. Establishing and strengthening relationships between professionals in different regions will help to optimize the multidisciplinary response to future large-scale disasters.