In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

  In hopes that inpatients can enjoy meals without worrying about foodstuffs, our hospital started buying more local fresh produce in January 2005 tuning in on the popular “Buy Local Produce” movement. We, employees of a hospital affiliated with the Federations of Agriculture Cooperatives for Health and Welfare, think it very important to support the movement, contribute to the improvement of the self-sufficiency in food and maintain good relationships with rural communities. The advantage of local produce is its safety. We can use it with a sense of security. At present, 10 farmers, who are members of the JA Isehara Co-op, deliver vegetables to the hospital. Initially, the hospital bought what they offered, but recently they grow vegetables of the kind the hospital wants. Now, local produce accounts for about 30% of the total value of the vegetables the hospital buys.However, prospects do not warrant any optimism, because the average age of the producers is 56 and it is not easy to increase the number of producers now. As far as items unavailable from the present producers are concerned, we have begun to buy these items from non-member farmers.

A 26-year-old man with Marfan's syndrome suffered aortic dissection repeatedly during hospitalization. He was admitted with a diagnosis of annuloaortic ectasia with severe aortic regurgitation. A type A aortic dissection occurred after diagnostic angiography. Three weeks after the onset of the dissection, an aortic root replacement in combination with a total arch replacement was performed. Eight months later, residual dissection in the descending thoracic aorta was replaced with distal perfusion by a temporary bypass from the left subclavian artery to the descending thoracic aorta. At the termination of the operation, abdominal aortic dissection occurred with acute bilateral limb ischemia, which was treated with abdominal aortic intimal fenestration. He recovered uneventfully and was discharged 3 weeks after operation. In light of our experience, because of vascular fragility, great care should be taken in treating patients with Marfan's syndrome to avoid iatrogenic aortic dissection.

Objective: Distigmine can cause cholinergic crisis as the side effect.  In 2010, the safety information of distigmine was announced and its dosage was changed up to 5 mg per day.  However, the malpractice that a pharmacist dispensed over dose of distigmine caused severe health damages in a community pharmacy.  Therefore, we made the protocol with the urologists for the appropriate use of distigmine, including contents of monitoring the side effects.  The purpose of this study was to measure using the protocol was useful for the propulsion of proper use of distigmine.
Methods: The protocol was introduced in 10 community pharmacies and 1 hospital pharmacy from December 2013 to April 2014, and the patients and pharmacists were filled out the answer to the questions that we have made.  The protocol consisted of five main checks; the dosage, lower urinary tract symptom, presence of renal disease, combined drugs, and signs of the side effects.  Each patient was filled out the checklist given by the pharmacist to monitor the signs of the side effects for 2 weeks.
Results: The 3 prescriptions of distigmine (18.8%) were more than 10 mg per day.  Although 2 patients were confirmed diarrhea and sweating etc., they were mild.  The pharmacists significantly more (p<0.05) answered that the protocol made their motivation to do the pharmaceutical interventions.  All of the patients answered that the pharmaceutical interventions made them relieved.
Conclusion: The use of protocol that we made supported pharmacists to do the pharmaceutical interventions and patients welcome them.

Objective: In 2000, the Ministry of Health and Welfare issued an advisory that recommended intake of 0.4mg of folic acid in dietary supplements to reduce the risk of development of neural tube defects.  Since subsequent reports of questionnaire surveys by various investigators showed a low in the intake rate, we surveyed and evaluated the folic acid intake rate among the pregnant women consulting the Japan Drug Information Institute in Pregnancy.
Methods: We evaluated differences in folic acid intake rate according to the consulting women’s background factors. i.e., age, pregnancy planning, pregnancy history, and taking of anticonvulsant drugs in the 1053 women capable of participating in the survey among the 1061 pregnant women who requested a consultation with the Japan Drug Information Institute in Pregnancy between April 2006 and August 2008.
Results: According to the result of our survey, the intake rate of folic acid was 29% of the 1053 pregnant women.  The only 3 women of the 42 pregnant women taking anticonvulsant drugs took folic acid before they got pregnant.
Conclusion: Even now, 8 years after the Ministry of Health and Welfare advisory, the folic acid intake rate is low.  Drawing upon successful measures promoting intake in the U.S. and Canada,we play a vital role in delivering this critical health information to pregnant women.

BACKGROUND/AIMS: The aim of this study is to investigate the degree of delayed gastric emptying (DGE) and evaluate how the severity of DGE affects gastroesophageal reflux disease (GERD) in neurologically impaired (NI) patients utilizing 24-hour multichannel intraluminal impedance pH measurements (pH/MII) and ¹³C-acetate breath test (¹³C-ABT) analyses. METHODS: ¹³C-ABT and pH/MII were conducted in 26 NI patients who were referred to our institution due to suspected GERD. At first, correlation analyses were performed to investigate the correlation between the ¹³C-ABT parameters and the clinical or pH/MII parameters. Thereafter, all patients were divided into 2 groups (DGE and severe DGE [SDGE] group) according to each cut off half emptying time (t(1/2), 90–170 minutes). Each pH/MII parameter was compared between the 2 groups in each set-up cutoff t(1/2). RESULTS: The mean t(1/2) of all patients was 215.5 ± 237.2 minutes and the t(1/2) of 24 (92.3%) patients were > 100 minutes. Significant moderate positive correlations were observed between both t(1/2) and lag phase time and the non-acid reflux related parameters. Furthermore, the patients in the SDGE group demonstrated higher non-acid reflux related parameters than those of the DGE groups when the cutoff was t(1/2) ≥ 140 minutes. CONCLUSION: The present study demonstrated that GE with t(1/2) ≥ 140 minutes was related to an increase of non-acid exposure reaching up to the proximal esophagus in NI patients, and indicating that NI patients with SDGE might have a high risk of non-acid GERD.
Breath Tests ; Electric Impedance ; Esophagus* ; Gastric Emptying* ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration