Introduction: Lidocaine has an analgesic effect by inhibitory action for peripheral nervous system. It is effective for the refractory pain of neuropathic, even a high amount of opioid injection may not relieve pain, resulting in neuropathic cancer pain or adverse effects of morphine. Case Report: A 51-year-old woman had esophageal cancer with severe refractory pain of neuropathic. The pain was not relieved by increasing the dose of opioid because of adverse effects and morphine intolerance. Continuous lidocaine infusion decreased the frequency and the extent of pain and the dose of opioid. The patient didn’t show any symptoms of an adverse effect by this lidocaine treatment. Conclusion: This treatment may be useful for refractory pain of neuropathic in a patient having morphine intolerance with terminal phase.

No Abstract Available.
Inovirus* ; Pandemics* ; Vibrio parahaemolyticus* ; Vibrio*

The Japan-Korea Primary Care Exchange Programme, which is an international project held by the Japan Primary Care Association and Korean Academy of Family Medicine, provides young family physicians opportunities to visit annual conferences and training programs each year. This article reports the history and several topics that Japanese delegates in 2018 learned about in Korea regarding family medicine: "Outpatient Department" "Health Information Systems" "Healthcare System for the Rapidly Aging Population," and "The Current Situation and Issues in Long-term Care Insurance."

To clarify the effects of varying skin temperature due to several types of clothing on temperature responses and heat-stress during exercise, we analyzed thermoregulatory responses while wearing various types of sportswear including soccer (SC), baseball (BB), and fencing uniforms (FU), and while wearing water-perfused suits (WS) and vests (WV) during exercise in a hot environment. We also compared these results with those obtained under a semi-nude condition (NU). Eight male subjects performed three 20-min cycling sessions at light intensity (250W/m²) in a room maintained at 28°C (wet-bulb globe temperature, WBGT). The experiment was performed under ten conditions, with six sets of clothing, WS and WV at 14°C (WS14, WV14), 20°C (WS20, WV20) and 26°C (WS26, WV26), and FU, SC, BB or NU. While wearing sport-swear, increases in esophageal (ΔTes), mean skin (Tsk), mean body (Tb) temperature, heart rate (HR), thermal sensation (TS) at the end of exercise, and total sweat loss (m_{sw, tot}) during exercise were significantly (p<0.01) higher in BB and FU than in NU. In comparison to WS or WV conditions, ΔTes was significantly (p<0.01) higher under WV conditions than under NU, while there was no significant difference in ΔTes between WS and NU. Tsk, Tb, HR, TS and m_{sw, tot} tended to be lower in WS14 and 20, and higher in WV26 than in NU. Under all conditions at the end of exercise, the ΔTes markedly increased when Tsk exceeded 34°C ; and ΔTes was significantly correlated with Tsk (r=0.861, p<0.01) for all conditions except WS14 and 20. For Tsk less than 34°C, however, ΔTes remained constant. ΔTes, Tsk, and Tb significantly correlated with HR (r=0.932, p<0.001), TS (r=0.888, p<0.001), and m_{sw, tot} (r=0.961, p<0.001), respectively. These results show that during light exercise under hot conditions, 1) in several types of clothing, a critical level of skin temperature causing core temperature elevation may exist, 2) cooling the skin temperature can alleviate heat-stress due to body temperature elevation, and 3) the semi-nude condition is the simplest method of alleviating core temperature elevation without using body cooling materials such as WS or WV.

The guidelines for the prevention of heat disorders during sports activities were established 13 years ago in Japan. Since then, various studies on preventive measures against heat disorders have been done, yielding new knowledge about its prevention. It has been reported that the incidence of heat disorders is high in children and the elderly, and heat acclimatization and clothing are the factors involved in this disorder. We proposed to lower the WBGT (wet-bulb globe temperature) limit for warning (discontinuation of hard exercise) from “28°C or more” to “25°C or more” (corresponding to an ambient temperature of 28°C) for non-acclimatized persons, children, the elderly, and persons wearing clothes covering the entire body. We also indicated that heat disorders can occur due to unpredictable causes, because the mechanism is very complicated.

The effects of fencing uniforms (U) on thermoregulatory responses were analyzed in both practical field investigation (PFI) and laboratory experiment (LE) . In PFI, six fencers (college-aged) performed regular fencing practice wearing U and wearing a short-sleeved shirt and pants (T) in summer. Rectal temperature (Tr), chest skin temperature (Tch), mask temperature (Tmk), heart rate (HR) and sweat rate (SR) were measured during fencing practice. In LE, seven male college-aged subjects performed three sessions of 20-min cycling at light intensity (250 W/m²) in a room temperature maintained at 28 WBGT (wet bulb globe temperature) . Esophageal temperature (Tes), mean skin temperature (Tsk), mean body temperature (Tb), HR, and SR were measured during exercise wearing U and in a semi-nude condition (N) . In both PFI and LE, increases in Tch, Tsk, Tb, Tes, Tr and SR were significantly (p<0.001) greater when wearing U than when wearing T and N. In PFI, the maximal value of Tr correlated significantly with the maximal values of Tch (r=0.513, p<0.001) and SR (r=0.635, p<0.001) during practice wearing U and T. In LE, positive correlations between Tsk and Tes (r=0.797, p<0.001), and between Tb and SR (r=0.658, p<0.02) were found at the end of exercise wearing U and N. In PFI, although the Tsk decreased within a few minutes of a decrease in Tmk, a significant relationship between the decrease in Tmk and Tsk or Tr was not observed during fencing practice. These results demonstrate that when wearing U, a higher skin temperature induces core temperature elevation, and higher skin and core temperatures are associated with increases in SR and HR during exercise in a hot environment. Thus, wearing light clothing during exercise, and taking off the fencing jacket and mask during rest periods would be recommended to reduce the heat stress during fencing practice in hot environments.

To clarify the effect of sports wear on exercise-heat stress, we analyzed quantitative differences in thermoregulatory responses among baseball uniforms (BB), soccer uniforms (SC), and swimming trunks (NU) during exercise in a hot environment. Eight male subjects performed three sessions of 20-min cycling at light intensity (250W/m²) wearing BB, SC and NU in a room maintained at 28°C (wet-bulb globe temperatures, WBGT) . Esophageal (Tes), mean skin (Tsk), and mean body temperatures (Tb), heart rate (HR), thermal sensation (TS), and total sweat loss (m_SW) were measured during the exercise. Increases in Tes, Tsk, Tb, HR, and TS during exercise were significantly (p<0, 05) higher, and m_SW, was significantly (p<0.001) greater for BB than SC and NU. The increase in Tes at the end of the exercise was 3.0 times higher for BB than NU ; and also 2.0 times higher for SU than NU. Under all conditions, the increase in Tes significantly correlated with Tsk (r=0.634, p<0, 001) and HR (r=0.854, p<0.001) ; m_SW also significantly correlated with Tb (r=0.683, p<0.001) at the end of the exercise. These findings suggest that quantitative differences regarding the increase in Tes among BB, SC and NU relate to Tsk elevation due to attenuation of heat dissipation depending on sports wear ; body temperature elevation also relates to the increase in HR and m_SW during light exercise in a hot environment.

OBJECTIVE: This study assessed the knowledge, attitudes and practices of the community residents on the prevention and control of Leptospirosis in the National Capital Region, Philippines.
METHODS: In this cross-sectional study, four-stage random cluster sampling proportional to size was used to select the 413 respondents from 30 villages in the National Capital Region. The mother or any responsible adult served as the respondent for the community survey which yielded data on the knowledge, attitudes, domestic practices, and sources of information for the prevention and control of Leptospirosis. Encoding was done using Epi Info Version 6. Descriptive statistics was generated through Microsoft Excel.
RESULTS: Majority of the respondents were able to correctly identify that the causative agent of leptospirosis is bacteria (91%), that the disease is transmitted by the urine of infected of rats (89%) through skin abrasions (71%) and mucous membranes (57%). Most commonly identified signs and symptoms of the disease include acute febrile illness with myalgia (87%), difficulty of breathing and decreased urine output (72%). Majority identified the prevention and control measures correctly. Wearing of boots, maintaining a clean and orderly house and maintaining good sanitation were the top answers of the respondents. In terms of attitudes, respondents had positive attitudes towards the preventive practices of wearing boots or following health advisories of authorities (99%). Majority also believed that leptospirosis is curable if detected early (99%) and that it is a serious disease (98%). Similarly, more than 90% had positive attitude when it comes to health care. Wading in flood waters (93%), walking barefoot (85%) and conducting clearing activities after flood (63%) were the commonly believed forms of exposure to the disease. In terms of domestic practices, respondents usually clean their surroundings (40%), avoid wading in floodwaters (25%), wear boots (21%) to protect themselves from acquiring leptospirosis. Primary sources of information on leptospirosis were the mass media (46%), health workers (17%) and the health facilities (14%). The most common educational materials read by the respondents were flyers (9%), posters (8%), and leaflets (7%).
CONCLUSION: In general, majority of the respondents were knowledgeable on the causes, signs and symptoms, and modes of transmission of leptospirosis, and had favorable attitudes towards the prevention and control measures against leptospirosis. However, when it comes to domestic practices, less than 40% actually implement measures for the prevention and control of leptospirosis. Respondents' main source of information was the mass media and very few have read educational materials containing information about the prevention and control of leptospirosis. 

Human ; Animal ; Male ; Female ; Bacteria ; Rodentia ; Jaundice ; Leptospirosis ; Abnormalities, Multiple ; Cross-sectional Studies ; Floods ; Health Facilities ; Health Personnel ; Limb Deformities, Congenital ; Mucous Membrane ; Myalgia ; Philippines ; Rats ; Sanitation ; Surveys And Questionnaires ; Attitude ; Urine

The Young Primary Care Doctors' Organization of the Japan Primary Care Association (JPCA) launched the "Generalist 80 Universities Angya Project" in 2011 to increase contact between generalists and medical students or residents interested in general hospital medicine, family medicine and primary care. The project targeted students interested in family medicine, primary care and hospital general medicine who do not participate in nationwide seminars. The project helps medical students and residents hold voluntary seminars at their university campus about family medicine, primary care and hospital general medicine. From 2011 to 2016, the project supported 129 seminars attended by 3,569 people at 63 universities. A questionnaire survey on 11 seminars between September 2013 and February 2014 revealed that 66% of medical students had never participated in JPCA family medicine summer seminars for students and residents. By holding seminars at university campuses, we targeted different participants from those at the nationwide seminar.

At present, lifestyle-related diseases are one of the most critical health issues worldwide. It has been reported that lipopolysaccharide derived from a Gram-negative bacteria (IP-PA1) symbiotic with wheat exhibited several advantageous biological effects, such as the reduction of plasma glucose levels in NOD mice and low-density lipoprotein (LDL) levels in WHHL rabbits. In this study, the beneficial effects on plasma glucose and lipids of a tea (SI tea) consisting of IP-PA1 and Salacia (which contains an inhibitor of alpha-glucosidase) were investigated in the KK-Ay/TaJcl type 2 diabetic model mice and in human subjects with premetabolic syndrome in a double-blind, randomized study. SI tea significantly decreased plasma glucose levels in KK-Ay/TaJcl mice. A clinical trial of SI tea was performed with 41 subjects between the ages of 40 and 69, who belonged either to a high plasma glucose group (HG: FPG 100-125 mg/dl) or to a hyperlipidemia group (HL: TG > or = 150 mg/dl, or LDL > or = 120 mg/dl, or HDL < 40 mg/dl). These subjects ingested either Salacia without IP-PA1 (the control) or SI tea. Blood samples were collected at 0, 30, and 60 days after initiating SI tea treatment, and were measured for FPG, HbA1c, TG, LDL, and HDL. These results showed that SI tea reduced FPG and HbA1c more rapidly than the control in the HL group, and also significantly improved LDL and HDL levels in the HG group. Thus, SI tea may be helpful in preventing lifestyle-related diseases.
Animals ; Cholesterol ; Fasting ; Glucose ; Gram-Negative Bacteria ; Humans ; Hyperlipidemias ; Lipoproteins ; Mice ; Mice, Inbred NOD ; Plasma ; Rabbits ; Salacia ; Tea ; Triticum