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

Purpose: The present study aims to evaluate the effect of analgesics in cancer patients based on their pain descriptions. Methods: The relationship between the words that patients used to describe their pain due to cancer and the efficacy of treatment with analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) or opioids was evaluated. Results: We recorded 529words that were used by 164patients to describe their pain and pain quality and classified them into 108types of pain.For patients who used the actual word 'dull' or one with a similar meaning, treatment with opioids was effective. However, treatment with opioids was less effective in patients who used words such as "numb" and "tingling". Conclusion: We were able to gain a good understanding of cancer pain by listening to the actual words that patients used when complaining of pain. These findings suggested that we could choose a suitable medication through evaluation of the actual words cancer patients used to describe their pain and successfully relieve their pain. Palliat Care Res 2009: 4(1): 207-213

INTRODUCTIONMyocardial scintigraphy with ¹²³I-15-(p-iodophenyl)-3-methyl pentadecanoic acid (¹²³I-BMIPP) is used to evaluate impaired fatty acid metabolism. B-type natriuretic peptide (BNP), which is secreted by the ventricular myocardium on stretching and/or pressure overload, is a useful cardiac biomarker. This study aimed to evaluate the usefulness of ¹²³I-BMIPP imaging and serum BNP levels in patients with heart failure (HF).

METHODS113 patients with HF were enrolled. There were 68 patients with ischaemic heart disease (IHD) and 22 with overt HF. Cardiac scintigraphy was performed 7 ± 3 days after admission, and heart-to-mediastinum (H/M) count ratios on early and delayed images and washout rates (WR) of ¹²³I-BMIPP were recorded. Serum BNP levels were recorded on the day of ¹²³I-BMIPP imaging. The ejection fraction (EF) was calculated just before cardiac scintigraphy using conventional echocardiography.

RESULTSThe mean BNP level and EF were 282 pg/mL and 47%, respectively, with significant correlation between them. The mean H/M count ratios on early and delayed images were 2.29 and 1.93, respectively, showing significant positive correlations with EF (r = 0.31, p = 0.0006). The WR was significantly correlated with EF (r = -0.36, p < 0.0001) and BNP levels (r = 0.33, p = 0.003), and mean WR was significantly higher in patients with overt HF compared to those without (p < 0.001). Patients with IHD had significantly higher EFs than those with non-IHD (p = 0.03).

CONCLUSIONThe evaluation of impaired myocardial metabolism using ¹²³I-BMIPP scintigraphy and serum BNP levels appears to be useful for the evaluation of severity of HF.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers ; metabolism ; Echocardiography ; methods ; Fatty Acids ; metabolism ; Female ; Heart Failure ; blood ; diagnosis ; diagnostic imaging ; Humans ; Iodine Radioisotopes ; Iodobenzenes ; Male ; Middle Aged ; Myocardial Perfusion Imaging ; methods ; Myocardium ; pathology ; Natriuretic Peptide, Brain ; blood ; Time Factors ; Treatment Outcome

BACKGROUND: Previous studies have suggested that exposures to heavy metals (arsenic, cadmium, lead, and selenium) may be associated with differences in blood pressure. However, the findings of these studies have been inconsistent. This study was performed to examine the associations between urinary heavy metal concentrations and blood pressure among residents of four Asian countries (Bangladesh, Indonesia, Nepal, and Vietnam). METHODS: This cross-sectional study examined 1899 adults in four Asian countries. Urinary concentrations of heavy metals were measured by inductively coupled plasma mass spectrometry. A questionnaire survey was administered regarding individual characteristics. Anthropometric measurements (height and weight) were performed. Systolic and diastolic blood pressures were measured after a short rest. Multiple linear regression models were applied to investigate associations between urinary heavy metal concentrations and blood pressure after adjustments for age, sex, and body mass index. RESULTS: The geometric means of the urinary concentrations of arsenic, cadmium, lead, and selenium were 84.6, 0.885, 2.09, and 16.5 μg/g creatinine, respectively. The urinary arsenic concentrations were slightly higher than those typically reported in non-polluted populations, while urinary cadmium, lead, and selenium concentrations were equivalent or slightly lower. The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure, but urinary selenium concentrations were negatively associated with them. CONCLUSIONS Variations in the urinary concentrations of lead and selenium were associated with blood pressure at low levels of exposure/intake.
Adult ; Arsenic/urine* ; Bangladesh ; Blood Pressure ; Cadmium/urine* ; Cross-Sectional Studies ; Environmental Exposure ; Female ; Humans ; Indonesia ; Lead/urine* ; Linear Models ; Male ; Metals, Heavy/urine* ; Middle Aged ; Nepal ; Selenium/urine* ; Vietnam