1.Self-medication by using antibiotics and pharmacists’ role
Satoru Kimura ; Yasuhide Nakamura
Journal of International Health 2014;29(2):81-90
Introduction
Sales of prescription-only drugs are not well regulated in developing countries. Self-medication with antibiotics is a major concern in global public health from the perspective of increased drug resistance. In addition to common self-medication with prescription-only drugs, distribution of dangerous counterfeit drugs is a social problem in Indonesia. This study aims to examine the factors relevant to self-medication with antibiotics by clarifying customers’ behavior requesting antibiotics at pharmacies and pharmacists’ response in the capital region of Indonesia.
Method
Two hundreds customers who requested antibiotics were exit-interviewed at 6 community pharmacies in the Ciputat district of South Tangeran City. Structured questionnaire was used on general attribute including health insurance coverage and having/not-having prescription and instructions by pharmacists, etc. Eight informants of pharmacists and an owner from a pharmacy were interviewed by using semi-structured questionnaire. They were questioned on number of customers requesting antibiotics with/without prescriptions, pharmacists’ responses and experience of health damages. The investigation was conducted between late May and early July of 2012.
Results
Of the customers requesting antibiotics, 48.5% (97/200) had no prescriptions. Neither consultation with doctor nor self-medication is statistically associated with health insurance coverage. Among customers without prescriptions, 51.9% (54/104) purchased antibiotics by showing drug samples they did not take. This was significantly more frequent than those following advice by family/friends or pharmacists. Pharmacists are cautious of dispensing antibiotics without prescriptions. They assess patients, being mindful of allergy and drug resistance. Pharmacists recognize the importance of patient education and intervention in the community.
Conclusion
The results of exit-interview suggested that economic reason is not a dominant factor to promote self-medication. From the observations among self-medicated customers who are on over-confidence, purchase antibiotics using drug samples they left over, and having preference of advice by family/friends to advice by pharmacist, self-medication is considered based on heuristic selection as well as risk-management within their limited scope of options. The efficacy of antibiotics is manifested in a short duration so that it gives efficient feedback as well as successful experience to patients. The successful experience is considered to strengthen patients’ behavior of self-medication. Pharmacists are expected to challenge their new role to develop patient education to alter patient behaviors.
2.New Strategy for Pharmacovigilance Using Data-Mining Methods in Pharmaceuticals and Medical Devices Agency
Chieko ISHIGURO ; Satoru NAKAMURA ; Kazuhiro MATSUI
Japanese Journal of Pharmacoepidemiology 2010;15(1):23-30
During FY 2004 through 2008, as one of the projects in the first medium term plan, the Pharmaceuticals and Medical Devices Agency(PMDA)had been engaged in the research and establishment of data mining method as an operational support tool to assist staff in charge of post-marketing safety measures, with the goal to implement this tool in April 2009.
This article was written with objective to demonstrate the current operation process of data mining in PMDA.
3.Acute effect of static stretching on passive and active properties of the gastrocnemius muscle–tendon unit: an investigation based on different repetition durations and numbers
Masatoshi Nakamura ; Tome Ikezoe ; Satoru Nishishita ; Jun Umehara ; Noriaki Ichihashi
Japanese Journal of Physical Fitness and Sports Medicine 2017;66(2):163-168
Many previous studies have reported that static stretching (SS) may decrease muscle stiffness and compromise muscles’ ability to produce maximal strength. However, the effects of SS at different repetition durations and numbers within a constant total time remain unclear. Therefore, the purpose of this study was to examine whether SS for a constant total time (2 min) with different repetition durations and numbers (e.g., 60 s × 2 times, 30 s × 4 times, and 10 s × 12 times) produces different changes in muscle stiffness and strength. Fifteen healthy males (mean age: 23.3 ± 1.0 years) participated in this study. Muscle stiffness was measured during passive ankle dorsiflexion using dynamometer and ultrasonography. In addition, muscle strength of the plantar flexors was measured using a dynamometer at 0° of plantarflexion with the hip and knee joints fully extended. Muscle stiffness and strength were measured before and immediately after SS. Each experimental protocol was conducted in random order with at least a 1-week interval but no longer than a 2-week interval between testing sessions. The results showed that there were no significant interaction effects on muscle stiffness and strength. However, in all experimental protocols, muscle stiffness and strength immediately decreased after SS. In conclusion, SS for a constant total of 2 min decreases muscle stiffness and strength regardless of repetition durations and numbers of each individual SS.
4.A Case of Severe Triple Vessel Disease Treated by Coronary Artery Bypass Grafting to the Proximal Circumflex Coronary Artery (Segment 11).
Teruya Nakamura ; Kazuhiro Taniguchi ; Satoru Kuki ; Hiroshi Takano ; Akihiro Okuda
Japanese Journal of Cardiovascular Surgery 1998;27(5):310-313
A 74-year-old woman was first admitted to our hospital for orthopnea, and was given a diagnosis of severe congestive cardiac failure caused by myocardial infarction. Coronary angiography revealed severe triple vessel disease, with a totally obstructed left anterior descending artery (LAD) and right coronary artery. First diagonal branch (Dx1) was 90% stenotic, and left circumflex artery was also 90% stenotic in its proximal portion (segment 11; #11). There was no stenotic lesion in the obtuse marginal branch or posterolateral branch, which are the usual target branches for the left circumflex branch (LCx). But they were too small to be grafted. Left ventriculography showed severe left ventricular dysfunction (ejection fraction; 31%). Saphenous vein grafting (SVG) to the distal portion of #11 and sequential SVG to the LAD and Dx1 were performed. Postoperative angiography proved that these grafts were patent. The patient was discharged on the 46th postoperative day after an uneventful course.
5.A case of POEMS syndrome treated by acupuncture
Kaori ISHII ; Satoru YAMAGUCHI ; Hiroshi OMATA ; Tomokazu KIKUCHI ; Shuji OHNO ; Yuichi NAKAMURA
Journal of the Japan Society of Acupuncture and Moxibustion 2009;59(5):486-494
[Object]Any reports on acupuncture for patients with POEMS syndrome, which almost manifests disturbance of peripheral nerve in all cases and is known as a very rare disease together with disturbance of multiple organs, are not yet found. The present paper is concerned with a case report that improvement of symptoms and progress of ADL were brought out by acupuncture.
[Case]A sixty year-old man who was diagnosed as POEMS syndrome and received rehabilitation therapy after treatment with autologous peripheral blood stem cell transplantation complained of difficulty in walking with numbness in the lower legs at rest time and with numbness and muscular tension in the same sections after walking. Therefore, acupuncture was practiced once or twice per week for the patient in order to raise the threshold of pain and to relax muscular tension in the lower extremities.
[Results]After acupuncture, the patient could lengthen the walking distance, had reduced numbness in the soles and relaxation of muscular tension in the lower legs at rest time, and improved numbness after walking.
[Discussion and Conclusion]Acupuncture for a patient with POEMS syndrome resulted in improved symptoms and progress of ADL without severe side effects. From the above results, acupuncture is considered to be a useful therapeutic method used together with present medical treatment.
6.Cancer and acupuncture & Moxibustion 3
Takayoshi OGAWA ; Masahiro KANAI ; Taneomi KUROKAWA ; Fumihiko FUKUDA ; Shunichi MAGARA ; Satoru YAMAGUCHI ; Ai KOUCHI ; Tatuzo NAKAMURA
Journal of the Japan Society of Acupuncture and Moxibustion 2010;60(4):693-706
This is the third symposium on 'cancer and acupuncture and moxibustion'. Many physicians and intellectuals are skeptical of the use of Western medicine for cancer patients, which often lead to serious adverse events. Acupuncture and moxibustion, which is capable of improving quality of life (QOL) and activating immunity with minimal side effects is also expected to have beneficial effects on various stages of cancer patients, such as prevention of development or recurrence of cancer and palliative care. In fact, evidence has recently accumulated in the field. Dr. Fukuda, Associate Professor of Meiji University of Integrative Medicine, who reported the usefulness of acupuncture and moxibustion in palliative care in the first symposium and bibliographical information in the second has reported this time on the topic of safety and effectiveness of acupuncture on chemotherapy-induced peripheral neuropathy. Dr. Kurokawa from the National Defense Medical College reported the effectiveness of acupuncture on physical and psychological symptoms, QOL, prevention of adverse events, and pre-and post-operative disorders in cancer patients. Dr. Kouchi from Saitama Medical School reported on the usefulness of acupuncture in the university hospital and factors which influence the effect. Dr. Nakamura from Morinomiya University presented a case with chemotherapy-related symptoms who had been cared for with a long-term application of moxibustion. In contrast to these reports on the efficacy of the acupuncture for chemotherapy-and radiotherapy-induced side effects, Dr. Magara from Somon Hachipuji Clinic, who had consistently reported a preventive effect of autonomic immune therapy that involves acupuncture without Western clinical treatment from the first symposium, this time presented topics regarding improvement in the immunity by increasing various cytokines, the possibility of reduction of a tumor even in a case of advanced cancer that cannot be treated with a surgical approach, reduction of the recurrence rate among cases who were treated with his approach as compared with those under conventional approaches. He insisted we should concentrate our efforts on research on preventing the recurrence of cancer with approaches that activates the natural healing process of human beings.
We concluded that clinical trials with a larger sample are needed to clearly identify the usefulness of acupuncture and moxibustion for cancer patients.
7.ANALYSIS OF GRIP STRENGTH EXERTION OF ATHLETES ACCORDING TO NATORI'S METHOD
KINJI UCHINO ; SEIJI SATO ; MITUGU OGURA ; SATORU IWASHITA ; SEIJI NIYOMURA ; YASUSHI NAKAMURA
Japanese Journal of Physical Fitness and Sports Medicine 1974;23(2):53-59
1) Tension development during rapidly grip strength exertion of athletes and nonathletes was by Natori's method analyzed.
2) Subjects of athletes were 71 healthy men of 17-26 ages and of non-athletes were 54 healthy men of 17-30 ages. Athletes were 26 high school students of 17-19 ages, 22 physical education college students of 19-21 ages and 23 general adult men of 20-26 ages. High school students were 3 Sumo-men, 4 Judo-men, 6 Kendo-men and 13 Baseball-men. Physical education college students were 6 Handball-men, 9 Rugby-men and 7 Gymnasticsmen. General adult men were 11 Judo-men and 12 Kendo-men. Non athletes were 20 high school students of 17-18 ages, 6 university students of 19-21 ages and 28 general adult men of 21-30 ages.
3) Isometric grip strength manometer were used a new device, to improvement on Smedley's manometer straingauge added.
Tension development were amplifired and recorded by portable Visigraph (Sanei-Sokki Ltd.) with paper-speed of 10cm/sec.
4) In the each case was 3 portions of a whole curve of time course of tension and Pmax.P1, P2; log t1, log t2; tan θ, tan ψ estimated according Natori's method.
5) Except general adults of 26-30 ages of non-athletes were Pmax. of athletes greater than non-athletes.
Pmax, of a Judo-man of general adult was greatest 68.5kg, and Pmax. of a high school student of 17 age of non-athlete smallest 35.8kg.
6) Tan θ and tan ψ of athletes were greater than non-athletes.
Tan θ of a Sumo-man of high school student was greatest 0.3628 and tan θ of a Judoman of general adult was greater 0.3500, but tan θ of a high school student of non-athletes was smallest 0.1624.
Tan ψ of a Kendo-man of general adult was greatest 1.6308 and tan ψ of a Sumoman of high school student was greater 1.5769, but tan ψ of a high school student of non-athlete was smallest 0.5278.
7) Muscle strength of non-athletes may well increased to be about 25 age, so that Pmax. of general adults of non-athletes were greater and of high school students of nonathletes smaller.
But athletes exercised usually for athletic sports, so that Pmax, and tan θ, tan ψ independent of age was greater than non-athletes, these were an each event varied. Pmax. of Judo-men of general adults were relative greater and tan θ, tan ψ were greatest. Pmax. of Handboll-men were greatest but tan θ, tan ψ were relative smaller. Pmax. of Gymnas-tics-men were relative greater but tan θ, tan ψ were smallest. So that were varied pattern of time course of tension development of hand grip exertion an each event of athletics.
8.The Effect of Spa Bathing on Infirm Individuals Receiving Home Care. Spa bathing available through Day Service and Day Care programs.
Akira DEGUCHI ; Satoru NAKAMURA ; Hitoshi HAMAGUCHI ; Yoichi KAWAMURA ; Yukio NISHIMOTO ; Yasuko TANII ; Katsumi DEGUCHI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1996;59(2):99-104
9.Both Spa Quality and Temperature Play a Role in Blood Fibrinolysis Activation as a Result of Spa Bathing.
Hitoshi HAMAGUCHI ; Akira DEGUCHI ; Satoru NAKAMURA ; Kenichi KAWAMURA ; Naoto KAWAMURA ; Yoichi KAWAMURA ; Katsumi DEGUCHI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1997;60(4):221-226
10.Night Spa Bathing for Patients with Senile Dementia.
Akira DEGUCHI ; Eri SUZUMURA ; Satoru NAKAMURA ; Naoto KAWAMURA ; Ken'ichi KAWAMURA ; Hitoshi HAMAGUCHI ; Yoichi KAWAMURA ; Kimiya SUGIMURA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2001;64(2):71-75
Spa bathing at night has been thought to improve sleeping conditions and symptoms of dementia such as restlessness, wandering, and aggression in patients in our nursing home with special needs for the aged. The present study investigated patient activity using a lifestyle measurement device (Kenz Lifecorder) to examine the effects of night bathing on senile dementia by more objective methods. Nine patients with senile dementia of the Alzheimer type staying in health facility for the elderly were studied. These patients' symptoms of dementia were already incurable but daily living activities somewhat remained. The patients were divided into a night bathing group (n=5) and daytime bathing group (n=4) to study patient activity using a Kenz Lifecorder for 14 weeks, that is one week before the start of bathing, 12 weeks with bathing, and 1 week after bathing. The night bathing group had a higher rate of activity than the daytime bathing group. When comparing the daytime of night bathing patients with the daytime bathing individually, the former displayed increased activity in the daytime. As a group, the night bathing group was found to show a significant increase in the amount of daytime activity. However, the statistical significance was reached after Weeks 9-10, so 2-3 months were required to change lifestyle rhythms. The authors hope that night bathing or night bathing assistance will be received favorably by the long-term care and health care insurance systems.