1.Medical Training in the United States and the United Kingdom
Nodoka ADACHI ; Aya NAKAJIMA ; Eri SUZUKI
Medical Education 2002;33(4):273-275
We three students of Saga Medical School visited medical centers in the United States and the United Kingdom as an elective course in the sixth year of medical education. One of us went to Sutter Medical Center, Santa Rosa, California, in the United States for 4 weeks, and two of us went to the University of Leicester in the United Kingdom for 4 weeks. These experiences led us to reconsider Japanese medical education, medical system, and hospital volunteers from different points of view.
2.Pigmentation by transdermal fentanyl patch
Hiroaki Shibahara ; Ei Sekoguchi ; Nagayuki Takeshita ; Shingo Suzuki ; Miho Morimoto ; Sachiko Inaguma ; Yoko Mori ; Sumiyo Kudo ; Yumi Ota ; Mika Nishimura ; Natsuko Uematsu ; Eri Imai ; Daisaku Nishimura
Palliative Care Research 2013;8(1):523-528
Introduction: There has been no case report in which hyperpigmentation developed on the skin area where a transdermal fentanyl patch was applied in a patient. Case report: A 43-year-old man with recurrence of postoperative rectal cancer was treated by cetuximab plus irinotecan and panitumumab plus FOLFIRI. For cancer pain, transdermal fentanyl patch (Fentos®) was administered, and radiation from behind was performed. Hyperpigmentation then appeared on the chest and the abdominal skin sites where the patches were applied. The hyperpigmentation nearly disappeared four months after the fentanyl patch was discontinued. Discussion: The cause of the pigmentation was possibly due to post inflammatory hyperpigmentation secondary to contact dermatitis. It was desirable to conduct patch test and skin biopsy for making an accurate diagnosis. Conclusion: We should pay a careful attention to hyperpigmentation of the skin where a transdermal fentanyl patch is applied.
3.Comparison of Medical Education in Japan with that in Thailand and Singapore
Hironari Matsuda ; Yu Orihara ; ShoSho Ra ; Chikashi Takano ; Akira Miyahara ; Akihiko Mohri ; Meiko Kimura ; Eri Shoji ; Kenji Suzuki ; Kazuhisa Takahashi ; Hiroshi Tsuda
Medical Education 2012;43(2):127-129
1)We had the opportunity to study medical education in Thailand and Singapore while we visited medical schools in those countries as a member of the Japan Tropical Medicine Association.
2)In Thailand, undergraduate medical education last for 6 years, which is the same length as in Japan. All lectures are in English. Medical students in Thailand are more deeply related to patients at bedside learning than are students in Japan. In Singapore, undergraduate education lasts for 5 years, and lectures are in English. In the third year, medical students start clinical medicine. Recently, a new program has been adopted in which medical students can easily choose their specialties right after graduation.
3)Japanese medical students study medicine in Japanese. In contrast, greater emphasis should be placed in Japan on medical education in English.
4.Nutritional status of calcium and other bone-related nutrients in Japanese type 2 diabetes patients.
Eisuke TOMASTU ; Eri NINOMIYA ; Mizuho ANDO ; Izumi HIRATSUKA ; Yasumasa YOSHINO ; Sahoko SEKIGUCHI-UEDA ; Megumi SHIBATA ; Akemi ITO ; Kazuhiro UENISHI ; Atsushi SUZUKI
Osteoporosis and Sarcopenia 2016;2(2):94-98
OBJECTIVE: Traditional Japanese food appears to be healthy but contains a small amount of milk products. Type 2 diabetes (T2DM) patients commonly reduce their energy intake to control their blood glucose levels. However, nutritional guidance for diabetes does not emphasize calcium (Ca) consumption. The aim of this study is to estimate the nutritional status of Ca and other nutrients, which affect bone and Ca metabolism, in T2DM patients. METHODS: This observational study was conducted with Japanese T2DM patients (n = 96; M/F = 50/46; age: 61.6 ± 10.1 years). We estimated nutrient intake using a simple food frequency questionnaire. RESULTS: Median total energy intake was 1750 kcal/day (1440-1970). Their median daily intake of Ca, vitamin D, and vitamin K was 451 mg (336-560), 10.2 µg (8.5-12), and 206 µg (84-261), respectively. Only 17.7% of the study subjects were found to take more than 600 mg/day of Ca. Protein and salt intake was 78 (64-90) and 10.6 (9.3-12.2) g/day, respectively. Male subjects had more salt, less Ca and vitamin K than female. Daily Ca intake was positively associated with total energy, protein, and lipid intake but not with carbohydrates. Vitamin D intake correlated only with protein intake. CONCLUSION: The daily Ca intake of Japanese T2DM patients appears to be insufficient and could depend on protein and lipid intake. Additionally, these patients should have specific recommendations to ensure sufficient intake of Ca with protein and lipid during energy restriction.
Asian Continental Ancestry Group*
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Blood Glucose
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Calcium*
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Carbohydrates
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Energy Intake
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Female
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Humans
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Male
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Metabolism
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Milk
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Nutritional Status*
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Observational Study
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Vitamin D
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Vitamin K
5.Sarcopenic Dysphagia and Simplified Rehabilitation Nutrition Care Process: An Update
Shingo KAKEHI ; Eri ISONO ; Hidetaka WAKABAYASHI ; Moeka SHIOYA ; Junki NINOMIYA ; Yohei AOYAMA ; Ryoko MURAI ; Yuka SATO ; Ryohei TAKEMURA ; Amami MORI ; Kei MASUMURA ; Bunta SUZUKI
Annals of Rehabilitation Medicine 2023;47(5):337-347
Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient’s pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.
6.Effects of Oral Rinse with Hangeshashinto Alone and Hangeshashinto with Honey for Oral Discomfort in Terminally-ill Cancer Patients
Satoshi MURAKAMI ; Asami IGARASHI ; Kanako MIYANO ; Yasuhito UEZONO ; Wakako YATSUOKA ; Takao UENO ; Eri SUZUKI ; Taeko ISHII ; Hiromi MATSUDA
Palliative Care Research 2019;14(3):159-167
Purpose: The purpose of this study is to evaluate hangeshashinto rinse for oral discomfort in terminally-ill cancer patients and to compare the effectiveness of hangeshashinto rinse with or without honey rinse. Methods: Patients with oral discomfort were randomized to receive either hangeshashinto rinse or hangeshashinto with honey rinse as first-line treatment. Patients performed oral rinse three to five times a day for 2 weeks. Further, oral wetness, halitosis, oral mucositis, mouth discomfort, compliance of rinse were then evaluated before and after the intervention. Results: 144 patients were enrolled during this period and 22 patients completed the study (hangeshashinto 13 / hangeshashinto with honey 9). After the intervention, oral wetness was improved, and end-tidal concentration of hydrogen sulfide was decreased in both cases. Although there was no statistically significant difference, oral discomfort by subjective and objective evaluations, also and symptom of oral mucositis were improved. Other volatile sulfur compounds decreased. Frequency of rinsing between groups receiving hangeshashinto or hangeshashinto with honey did not differ, however, the acceptability was slightly better in the honey combination group. Conclusion: Both hangeshashinto rinse and hangeshashinto with honey rinse reduced end-tidal concentration of hydrogen sulfide and improved oral wetness. Oral rinse by hangeshashinto or hangeshashinto with honey may be effective for oral discomfort in terminally-ill cancer patients.