Patients who need self-injection of insulin are educated beforehand to handle vials and syringes without bacterial contamination. However, not a few of them forget what they were told about the sterile technique during a long period of injection at home. Since 1988 a pen-typesyringe, which is considered to be more potent against bacterial contamination because of its mechanical structure, has become available in Japan. The aim of this study is to detect the percentage of contaminated vials in the patients' home and to compare traditional vials with pen-type vials in terms of potency against contamination. Two hundred eight vials were collected from 168 patients. Four traditional vials out of 163 (2.4 %) and 1 pen-type out of 45 (2.2%) were contaminated. Propionibacterium acnesgrew up from 2 vials, staphylococcus epidermidis from 2 vials and unidentified gram (+) rods from 1 vial. The patients using contaminated vials were from 30 to 65 in their age, enough skillful to handle syringes, good or poor in the control of DM and without disturbed vision. Thus, the contamination may have been derived from their technical deterioration after several years of injection at home. Therefore, re-education to keep their sterile technique should be given to them at appropriate intervals at the out-patient clinic.

The first step of cancer medical treatment is to eliminate anxiety about opioids. It is recommended to use printed matter in the "Guideline for Cancer Pain Management" edited by Japanese Society of Palliative Medicine,but few medical professionals actually use it. We developed the Opioids' pamphlet designed by Aichi Prefectural Society of Hospital Pharmacists; abbreviated OPA. This pamphlet is little burdened for readers; focusing on eliminating anxiety about opioids. Evaluation of the utility of the OPA and the actual conditions of patient education about the use of opioids by medical professionals were investigated, since there have been no reports on these issues. A questionnaire survey was conducted in hospitals with more than 150 beds in Aichi Prefecture. It targeted doctors, pharmacists and nurses who were practicing palliative care using opioids. There were many pharmacists and nurses who had been consulted about opioids, and most of the consultations were about addiction. 60% of pharmacists and 30% of nurses voluntarily performed patient education. Awareness of the guideline for of cancer pain management was low. OPA, which was reviewed based on the guideline, was applicable to 99% of the cases where the nurses were consulted. Its size and contents were highly acclaimed. Therefore, OPA is extremely valuable in clinical practice. Palliat Care Res 2009; 4(1): 214-227