Introduction
 Developing countries have many urgent issues to cope with, such as infectious diseases, and therefore people with disabilities have not had enough opportunities to receive rehabilitation services. A mobile unit as an outreach approach seems to be valuable in countries or areas lacking in adequate health care facilities. In Thailand, there are about 56 thousand people with lower extremity amputations. There are very few workshops and technicians in health care facilities producing prostheses. We studied a working mobile unit to clarify its effectiveness.
Method
 We conducted participatory observations of the mobile unit in Chiang Rai, Thailand in October, 2006 run by the Prostheses Foundation, and hearings from the staff and the amputees to collect the information such as outlines of the foundation and the unit, and the number of participants. We collected data on those amputees from the reception note, such as their occupations, causes of amputations, kinds of prostheses, and their experiences of using prostheses.
Results
 The mobile unit was a huge scale activity including 75 staff members, who visited the field with all necessary equipments. Fifty-four technicians produced 204 prostheses for 177 amputees in 4 days. Eighty percent of those amputees were unstable in income, such as farmers and those unemployed. Landmines were the cause of amputation for 20 percent of those seen. Thirty percent experienced their prostheses initially, 20 percent of whom had waited for 6 years or more to receive them. Therefore, it was found to be an effective activity to provide prostheses for poor people with amputations in rural areas. Also, technicians in rural areas learnt skills regarding prostheses from specialists in cities.
Conclusions
 A mobile unit seems to be effective in Thailand to provide amputees with prostheses, and Prosthetics and Orthotics technicians in rural areas with opportunities for education.

BACKGROUND/AIMS: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascular invasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. METHODS: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUS image findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion, types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors and evaluated vessels. RESULTS: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in the veins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings were significantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0–742] µm vs. 2,833 [1,076–5,694] µm, p=0.012) and arteries (623 [0–854] µm vs. 3,097 [1,396–6,000] µm, p=0.0061). All cases with a distance of ≥1,000 µm between the tumors and main vessels were correctly diagnosed. CONCLUSIONS: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.
Arteries ; Diagnosis ; Endosonography ; Humans ; Pancreatic Neoplasms ; Retrospective Studies ; Sensitivity and Specificity ; Veins

At Anjo Kosei Hospital, patients receive injectable medication for diabetes treatment and devices for self-monitoring of blood glucose as in-hospital prescriptions. Pharmacists manage prescriptions according to established protocols when there is over- or under-prescribing. In this study, we retrospectively examined outpatient prescriptions for patients attending endocrinology and diabetology from January 2014 to June 2015 (before protocol implementation) and from July 2015 to December 2020 (after protocol implementation) to evaluate the usefulness of protocol-based supporting prescription by pharmacists. Changing prescriptions based on the protocol simplified prescription queries in 661 of 721 cases (91.7%), and significantly decreased the rate of unplanned doctor visits after the introduction of the protocol (p<0.05). Optimization of prescriptions through protocol-based assistance in prescribing is expected to reduce the burden on physicians, patients, and pharmacists by reducing the number of formal inquiries for questionable prescriptions and the number of unplanned doctor visits.