Objective: We analyzed articles in the Japanese Journal of Drug Informatics with the goal of identifying recent research trends in drug informatics.
Method: The appearance frequencies of keywords in the Japanese Journal of Drug Informatics (2001: vol. 3 (1) to 2009: vol. 11 (4)) and Japanese Journal of Pharmaceutical Health Care and Sciences (2009: vol. 35 (1) to (6)), and words in abstracts in Japanese Journal of Drug Informatics (2009: vol. 11 (1) to 2010: vol. 12 (4)) were analyzed.
Results: To investigate keywords in the Japanese Journal of Drug Informatics, appearance frequencies of information, drug, drugs and pharmacist in 2001: vol. 3 (1) to 2003: vol. 5 (4), those of information, drug, drugs, medical, medication and questionnaire in 2004: vol. 6 (1) to 2006: vol. 8 (4), and those of information, drug, questionnaire, survey, pharmacist, adverse and generic in 2007: vol. 9 (1) to 2009: vol. 11 (4) were higher than those of other keywords.  In the Japanese Journal of Pharmaceutical Health Care and Sciences, appearance frequencies of drug, pharmacy, care, patient, pharmaceutical, cancer, education, training, analysis and drugs were higher than those of other keywords.  Information, drug(s), patients, pharmacists, hospital, use, questionnaire, medical, adverse, survey, agents, generic and pharmaceutical were high frequency words used in abstracts published in the Japanese Journal of Drug Informatics.  These words in abstracts indicate a Zipf’s law-like rank distribution.  Co-occurrence network graphs using abstracts showed that the first cluster consisted of medical, drug, adverse, drugs, pharmaceutical, hospital, doctors, contents and drug around information and pharmacists as hubs, and the second cluster consisted of 3 words (agents, woman and pregnant).  Furthermore, co-occurrence network graphs indicated that care, medical, pharmaceutical, information, adverse, pharmacists, hospital, doctors, questionnaire, woman, pregnant, package and side were matters of important arguments and/or phenomena.
Conclusion: These data suggest that the scope of themes in articles published in the Japanese Journal of Drug Informatics is establishing definitive categories.  The recent themes and contents of the Japanese Journal of Drug Informatics were closely and mutually related.

A 62-year-old woman with idiopathic thrombocytopenic purpura (ITP) was admitted to undergo cardiac surgery for aortic stenosis, angina pectoris, and paroxysmal atrial fibrillation. A bleeding tendency was expected due to the dramatic decrease in platelets during cardiopulmonary bypass. We performed high-dose transvenous gammaglobulin infusion (400mg/kg/day) for 5 consecutive days immediately before surgery. The gammaglobulin therapy caused steady increase of thrombocytes from 4 days after surgery, even though the platelet count showed no significant change preoperatively. The postoperative course was satisfactory with neither a bleeding tendency nor wound infection. High-dose transvenous gammaglobulin therapy is thus useful for perioperative patients with accompanying ITP, who are often under medication with steroids. This therapy is also effective for prevention of infection.

In the presence of Leriche syndrome, the lower extremities are perfused by collateral flow from internal mammary arteries. If an internal mammary artery graft is used in coronary artery surgery, an acute ischemic limb will develop postoperatively. A 52-year-old man was admitted to our department with bilateral claudication. Multidetector row computed tomography with contrast showed total occlusion of the infrarenal abdominal aorta and rich collateral flow to the lower extremities from internal mammary arteries. Cardiac angiography revealed three-vessel disease. Simultaneous coronary artery bypass grafting and an ascending aorto-bifemoral bypass were performed without cardiopulmonary bypass. Postoperative computed tomography angiography showed that grafts to the coronary and bifemoral arteries were patent. This combined procedure is useful for patients with coronary artery disease and aortoiliac occlusive disease. This procedure without cardiopulmonary bypass has not previously been reported.

Purpose: With the aim of improving the efficiency of smoking cessation treatment, we analyzed and classified various factors to identify the relationships between the background of patients and effects of treatment, and examine their characteristics.
Methods: We conducted a questionnaire survey to collect information on the situation of patients, and obtained their treatment data from medical records.  Decision tree analysis, a data mining method, was employed to examine these data.
Results: According to the results of the survey, the smoking cessation rate was 80.4%.  The rate was associated with CO concentrations in the breath at the initial examination, nicotine content in cigarettes smoked by patients, and the daily and total number of cigarettes smoked.  The smoking cessation rate among patients under emotional stress was 76.2%; the rate was higher when patients were able to reduce their mental stress levels.
Conclusion: We identified characteristic relationships between the background of patients and the effects of treatment, and they proved to be useful for the improvement of the smoking cessation rate.

  Our palliative care team intervened in a patient with sciatica resulting from metastasis to sacral bone after surgery for rectal cancer. Rapid pain control and a change in the route of rescue drug administration from the stoma were needed. Partial opioid rotation was performed. The dose of 25.2 mg in 72 hours in a transdermal fentanyl patch decreased to 16.8 mg in 72 hours, and the dose of 3.6mg in an hour by continuous intravenous injection of morphine was added. The change in the rescue root to intravenous administration by a patient-controlled analgesia pump gave the patient relief from his pain. He was able to attend his daughter's wedding. His family were all pleased with the relief provided. The advantages of this partial opioid rotation are summed up in the following three points: (1) The required time is relatively short; (2) It can be expedient for analgesia due to the addition of different opioids; and (3) The partial opioid rotation produces fewer adverse effects than a full opioid rotation. Adjustment of the amount of drugs for pain relief in cancer patients is important with the situations of the patient and the family taken into consideration fully.

We collected and analyzed large-scale data concerning the fall of stroke inpatients in convalescent rehabilitation wards. Three hundred seventy-four of 1,107 inpatients experienced one fall or more, and 16 factors associated with falls were clarified by the chi-square test. To extract the significant item from a multifactor, the logistic regression analysis of 16 factors was carried out, and we developed an assessment sheet for the risk degree of first fall prediction in stroke inpatients. We selected eight variables as the items on the assessment sheet : history of previous falls, central paralysis, visual impairment, sensory disturbance, urinary incontinence, use of psychotropic medicines, mode of locomotion, and cognitive impairment. The total score of the assessment sheet was ranged from 0 to 10 and the mean score of fallers (6.4±1.5) among subjects was significantly higher than that of non-fallers (5.1±1.9) (p <0.001). When the subjects were classified into three groups, a significant difference (p<0.001) in the tendency of fall incidence in term of days after admission was found among the three groups on the basis of the Kaplan-Meier survival curve.

Post-polio syndrome (PPS) is the term used to describe the symptoms that may develop many years after acute paralytic poliomyelitis( APP). In the case of PPS, the symptoms and signs include progressive muscle wasting and weakness, limb pain, and/or fatigue, occurring one or more decades after maximal recovery from APP. An overuse of enlarged motor units is suspected to cause the deterioration of some nerve terminals or the loss of the motor units themselves. This could in turn induce PPS symptoms such as new muscle weakness and atrophy. Electromyography (EMG) is often a strong tool to diagnose and evaluate PPS. Some studies have shown that mild to moderate intensity muscular strengthening has a positive effect in patients affected by PPS. Rehabilitation for PPS patients should utilize a multiprofessional and multidisciplinary approach. PPS patients should be advised to avoid both inactivity and overuse of the affected muscles. Finally, patient evaluation is often required to access the need of orthoses and assistive devices.

The number of patients with osteoporosis is an estimated 12,800,000 in Japan. Osteoporosis represents a risk factor for becoming bedridden, and also for increased mortality. It would thus be important to take measures to prevent non-examination and treatment interruption as their rate is high. We recruited participants at a health-supporting event for local residents at our pharmacy on April 14, 2019 and obtained consent from 40 individuals to participate in this study. At this event held by a pharmacy, we conducted bone density measurement and osteoporosis-related preventive education by pharmacists, considering the influence the event had on health-related awareness and behavior in the local residents. Knowledge of osteoporosis was higher after than before the events. Participant health and lifestyle awareness was not observed between before the event and one month after the event. However, one month after the event, several changes could be observed in the behavior of 79.4% (27/34) of the participants. Based on these results, bone density measurement and osteoporosis-related preventive education by pharmacists are suggested to increase osteoporosis-related knowledge among local residents and to promote behavior change related to healthcare and osteoporosis.