The purpose of the present study is to investigate protein metabolism during rapid weight reduction. Six male boxing players put on a restricted diet of their own accord for two weeks. Body weight changes were observed and a biochemical analysis was made of their urine and blood. The initial body weight of 66.1±3.0kg (mean±SE) decreased to 63.6±3.2 kg after two weeks (P<0.01) . The changes in lean body mass (LBM) by weight reduction were not significant, but the LBM tended to decrease after two weeks. The mean caloric intake was 2, 791±728 kcal before the study and 1, 643±548 kcal after two weeks. The reduction of carbohydrate consumption is much more than that of fat and protein consumption. The 3-Me/Cr in urine increased significantly after two weeks (348.1 ± 37.0 μol/g to 508.1 f 45.6 μmol/g, P<0.01) and the increase of Urea-N/Cr in urine (8.4±0.5mg/mg creatinine to 13.7±1.3mg/mg creatinine, P<0.01) was also significant after two weeks. Urine volume decreased significantly after two weeks (P<0.01) . There was no significant difference in the blood components during the weight reduction period. These results might suggest that rapid weight reduction and massive decrease of carbohydrate intake accelerate protein catabolism.

Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced enteritis or oral mucositis. It has been reported that hangeshashinto has been used for not only enteritis but also oral mucositis. This study reports the effect of hangeshashinto on enteritis or oral mucositis caused by radiotherapy. Three patients with enteritis and 5 patients with oral mucositis were treated with hangeshashinto at a dose of 7.5 g/day. The severity of enteritis or oral mucositis was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale both before and after hangeshashinto treatment. After the treatment with hangeshashinto, 3 of 5 patients with oral mucositis and 2 of 3 patients with enteritis showed apparent improvement. In conclusion, it is important to control the side effects of radiotherapy, which lead to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

Objective: Information on medicines brought to hospital by inpatients is essential to optimize drug use and patient safety.  However, the actual situation and usefulness of identifying such medicines on the emergent admission of patients remain to be clarified.  The objective of this study was to examine the usefulness of identifying the medicines patients bring to the hospital on emergent admission.
Methods: We compared the source of information on identifying medicines between two groups of patient: emergent admissions (N=276) and elective admissions (N=50), and also investigated intervention by pharmacists regarding the medicines patients had brought with them.
Results: Regarding the source of information to identify the medicines, the rate of utilizing medicine notebooks on emergent admission was significantly lower than on elective admission, and the rate of inquiring with community pharmacies on emergent admission was significantly higher than on elective admission.  The frequencies of intervention by pharmacists in the two groups were similar, and, therefore, the usefulness of identifying the medicines patients brought was noted regardless of the admission course.
Conclusion: Identifying the medicines patients bring to the hospital might be useful on emergent admission.  Hospital pharmacists should promote an increase in the medicine notebook utilization rate and reinforce cooperation with community pharmacies.

Background: Previous surveys have demonstrated that a significant proportion of inpatients did not receive adequate pain management at an acute care hospital in Japan. Aim: The aim of this study was to evaluate the usefulness of a hospital-wide audit for assessing pain management with opioids according to the electronic medical records (EMRs) Methods: The subjects of this audit were inpatients receiving strong opioids who had not been consulted by the pallia. tive care team (PCT). The PCT held a weekly pharmacist-led conference to evaluate the adequacy and appropriateness of analgesics, including opioids, as well as drugs administered for adverse effects according to information collected by the PCT pharmacists. The PCT subsequently recorded the advisory comments in the EMRs. Each week, the PCT monitored whether the suggestions had been accepted by primary physicians and whether the pain and/or adverse effects had improved. Results: Among a total of 4,978 cases evaluated during the 3-year survey period, 888 (17.8％) had inadequate pain and/or adverse effect management. Symptoms improved in 82.3％ of cases for which PCT proposals were accepted. Conclusion: The results suggest that this hospital-wide audit may be useful for improving pain management with opioids at an acute care hospital.

The prevalence of seasonal allergic rhinitis (hereinafter “hay fever”) is increasing annually. While self-medication with over-the-counter (OTC) drugs is growing, some hay fever patients also use OTC drugs alongside medical visits. Issues arising from co-administration, such as excessive dosing and reduced quality of life (QOL) due to drowsiness, have been highlighted. However, no research has investigated the factors contributing to the concomitant use of prescribed and OTC drugs. Therefore, this study examined the following three patient groups: those using only prescribed drugs, those using only OTC drugs, and those using a combination of both. Initial analyses compared adherence, overuse extent, QOL (as measured by the Japanese Rhino-conjunctivitis Quality of Life Questionnaire [JRQLQ]), treatment satisfaction, lifestyle habits, and health literacy (as measured by the Communicative and Critical Health Literacy Scale [CCHL]) among the groups. Subsequently, a multinomial logistic regression analysis focusing on combination users identified factors associated with co-administration. The results revealed that combination users exhibited lifestyle issues and lower QOL compared to those using prescribed or OTC drugs only, although differences in CCHL were not significant. Furthermore, co-administration was linked to social life-related JRQLQ and excessive usage during symptom onset. In conclusion, patients with hay fever should avoid the concurrent use of prescribed and OTC drugs. Co-administration may not necessarily improve symptoms and might even lead to overuse risks. Thus, patients should be guided to consult medical professionals before purchasing OTC drugs, and lifestyle improvements should be emphasized as well.

Objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant B.1.1.529 (Omicron) was first detected in Japan in November 2021. In Osaka, public health centres subsequently increased active case finding and encouraged self-isolation. This study investigated the effectiveness of these countermeasures. Methods: Cases targeted for analysis were persons who had neither recently travelled abroad nor had contact with foreign tourists but tested positive for SARS-CoV-2 between 24 November 2021 and 4 January 2022 and were suspected or confirmed to have the Omicron variant. We performed a descriptive analysis and calculated the reproduction number (R) for each generation using the branching process method. Genomic sequencing data were analysed to plot a haplotype network. Results: A total of 251 cases were analysed. The median age was 30 years, and 46% (115/251) were in their 20s or younger. The first Omicron case in Osaka was detected on 21 December 2021. Local public health centres conducted health monitoring and contact tracing. We analysed R, using information from six clusters, including 42 pairs with a clear relationship between the case and the infected contact (infector–infectee pairs); the clusters had 19, 21 and 2 cases in each subsequent generation. The basic R (t = 0) was estimated to be 3.2, and subsequent generations (t = 1, 2) of R decreased to 1.1 and 0.1, respectively. The haplotype network showed that these cases constituted a monophyletic group with others detected around Osaka, indicating that these case-related clusters had been contained and were not involved in the nationwide Omicron waves. Discussion: Active case finding and self-isolation were found to be effective in limiting the spread of an emerging novel variant.