Objective: To clarify consumer views on the new sale system of non-prescription drugs, self-medication, and purchases in drugstores after the revised Pharmaceutical Affairs Act in 2009.
Methods: The questionnaire was performed for 1,084 consumers on an enlightenment event of the proper use of non-prescription drugs and promotion of adequate self-medication held at Shinjuku Station that was a main terminal station.
Results: Among the respondents, the degree of recognition of the new sale system for non-prescription drugs was 67.7%.  There was approximately threefold increase from the previous survey in 2008.  The most common positive reason was, “The safety of non-prescription drugs was clarified by classification according to three risk levels.”  On the other hand, the most common negative reason was, “I was unable to reach the medicine I wanted without having to listen to the pharmacist’s explanation.”  When consumers want to purchase non-prescription drugs, 77.1 and 44.5% of the respondents nominated “pharmacy and/or drugstore” and “a convenience store,” respectively.  The practice of self-medication positively correlated with the words “the self-medication.”  In this study, a surge in consumer interest for self-medication and non-prescription drugs was felt.  However, while consumers were interested in the safety of non-prescription drugs, they also demanded convenience.
Conclusions: We thought that the role of experts such as pharmacists and registered salesclerks was to ensure safety, convenience, and understandability of consumers for non-prescription drugs.  In addition, to promote adequate self-medication, it was suggested that recognition of the words “self-medication” will be helped through events, the Internet, and the mass media.  It needs to be further explored.

　This report summarizes the Inohana Interprofessional Education （Inohana IPE） program and describes its current achievements and improvement process. Since 2007, a total of 5,679 students have participated in the program. Students who have graduated include 335 from the Faculty of Nursing, 197 from the Faculty of Medicine, 84 from the Faculty of Pharmaceutical Sciences.
　Through Inohana IPE we have created an environment that encourages students’ self-directed learning and the setting of behavioral objectives and have refined the program contents and evaluation method. As the first phase of the improvement, we developed competencies for interprofessional collaboration with 6 components and then created a matrix of learning-achievement goals and 4 learning steps based on the competencies. Furthermore, the number of faculty members participating in the program has increased.
　The two main tasks for the future are to develop an IPE program for nursing and to integrate IPE for basic education and continuing education.

Case: A 40-year-old woman. Clinical diagnosis: Autistic disorder with mild mental retardation. Case report: The patient underwent pancreaticoduodenectomy for the treatment of her pancreatic cancer. We held several conferences with individuals from different medical fields and examined the influence of the patient's autistic disorder on the perioperative conditions. The senior author, a clinical psychologist, conducted repeated individual, acceptive, and sympathetic interviews with the patient and her family and maintained supportive relationships with them as an honorary family member. Thus, the clinical psychologist helped reduce the patient's anxiety about the medical treatment. Conclusion: The participation of a clinical psychologist in the medical conferences enabled the medical staff to understand the complications involved and provide mental support to the patient and her family. Palliat Care Res 2010; 5(2): 323-326

Today, well over 160, 000 patients undergo dialysis throughout Japan. The number of patients who are newly required to receive it is increasing year by year. Given that situation, our hospital has annually held a seminar since October 1994 for patients with renal diseases. The purpose is to slow the deterioration of renal function and to delay the introduction of dialysis by encouraging the patients to acquire a habit of taking high calory, low protein food.
This seminar must have help the patients get more knowledgeable about morbidity and learn the benefit of low protein rice-based diet. Now that three years have passed since the opening of the course, we reviewed the outcome, comparing the effects of old and new restrict diets.
A difference began to appear 9-2 months after the lst seminar between the seminar participants and the non-participants (control group) who received guidance only at the outpatient ward. The average rate of decrease in the serum creatine level of those participants who eated lowprotein rice was 0.029 and that of those participants who did not eat the restricted food was 0.166 (p<0.05), compared with 0.262 in the control group. We concluded that the difference is ascribable to the effect of the seminar. We would like to contribute to the well-being of the patients by enriching the content of the seminar and continuing to hold it.

Objective: Macrolide therapy has been recommended as an effective treatment for pediatric otolaryngology patients with conditions such as chronic sinusitis and otitis media with effusion.  However, in many cases, a relapse may occur after cessation of treatment.  Therefore, patients are compelled to continue taking antibiotics.  In this paper, we examined the relationship between the duration of therapy and period to relapse on the basis of prescription information and literature research.
Methods: To evaluate the therapeutic doses, we investigated the clinical doses of erythromycin and clarithromycin used for pediatric patients in a community pharmacy from January 2009 to July 2009.  Further, we performed literature searches on the doses of both drugs using Igaku-Chuo-Zasshi databases (from 1983 to 2011) and compared the data obtained with the clinical doses.  Accordingly, the oral doses of macrolides were classified as a low dose or normal dose.  We analyzed the relationship between the administration period and the cessation period, which was defined as the period from the cessation of the treatment to relapse.
Results: Review of the 17 selected reports and the clinical doses showed that the maximum dose of erythromycin was 15 mg/kg/day and that of clarithromycin was 8 mg/kg/day during therapy.  When both cephem or penicillin antibiotics and low-dose macrolides were taken continuously during the administration period, a weak correlation was observed between the administration period and the cessation period.
Conclusion: These results may be useful for the appropriate use of antibiotics and for preventing relapse in pediatric otolaryngology patients.

Kanzoshashinto consists of seven medicinal herbs including ginseng. The formula for kanzoshashinto in the Chinese medical text “Jinguiyaolue” consists of the seven herbs, but its formula in “Shanghanglun,” a second medical reference, lists only six herbs and does not include ginseng. We investigated if formulas for kanzoshashinto in traditional Chinese and Japanese medical books included ginseng. We searched modern Japanese databases using the terms kanzoshashinto and ginseng. We also searched medical books written during the Song Dynasty in China and the Edo period in Japan. We found one article in a modern Japanese database that discusses kanzoshashinto and ginseng. The article stated that kanzoshashinto formula included ginseng only described in the Song medical text Jinguiyaolue. Kanzoshashinto formula in other ancient Chinese medical references did not list ginseng as one of the components of the medicine. This research confirmed the statements written in ancient Chinese medical references : doctors could add ginseng to kanzoshashinto. During the Edo period in Japan, most doctors prescribed a kanzoshashinto formulation that included ginseng. In the medical reference “Jinguiyaolue,” kanzoshashinto with ginseng is described as a treatment for kowaku, an unstable psychological state. In the medical reference “Shanghanglun,” kanzoshashinto without ginseng was used to treat severe diarrhea. Therefore, it is possible that kanzoshashinto without ginseng might be a more effective treatment for diarrhea. Further studies are required to examine the efficacy of kanzoshashinto without ginseng in treating severe diarrhea.

BACKGROUND/AIMS: The influences of Helicobacter pylori eradication therapy on the disease course of inflammatory bowel disease (IBD) are still unclear. We therefore conducted a multicenter, retrospective cohort study to evaluate the safety of H. pylori eradication therapy for IBD patients. METHODS: IBD patients with H. pylori eradication from 2005 to 2015 (eradication group) and control patients (non-eradication group; 2 paired IBD patients without H. pylori eradication matched with each eradicated patient) were included. IBD exacerbation (increased/additional IBD drug or IBD-associated hospitalization/surgery) and disease improvement based on the physicians’ global assessment were investigated at baseline, and at 2 and 6 months after eradication or observation. RESULTS: A total of 429 IBD (378 ulcerative colitis, 51 Crohn’s disease) patients, comprising 144 patients in the eradication group and 285 patients in the non-eradication group, were enrolled at 25 institutions. IBD exacerbation was comparable between groups (eradication group: 8.3% at 2 months [odds ratio, 1.76; 95% confidence interval, 0.78–3.92; P=0.170], 11.8% at 6 months [odds ratio, 1.60; 95% confidence interval, 0.81–3.11; P=0.172]). Based on the physicians’ global assessment at 2 months, none of the patients in the eradication group improved, whereas 3.2% of the patients in the non-eradication group improved (P=0.019). Multivariate analysis revealed that active disease at baseline, but not H. pylori eradication, was an independent factor for IBD exacerbation during 2 months’ observation period. The overall eradication rate was 84.0%–comparable to previous reports in non-IBD patients. CONCLUSIONS: H. pylori eradication therapy does not alter the short-term disease activity of IBD.
Clarithromycin ; Cohort Studies ; Colitis, Ulcerative ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammatory Bowel Diseases* ; Metronidazole ; Multivariate Analysis ; Retrospective Studies

BACKGROUND: Although fat accumulation in human organs is associated with a variety of diseases, there is little evidence about the effect of a fatty pancreas on the development of subclinical chronic pancreatitis over the clinical course. METHODS: We conducted a prospective cohort study from 2008 to 2014 of patients who underwent a medical checkup consultation for fat accumulated in the pancreas. Patients included in the analysis were divided into a non-fatty pancreas group (n = 9710) and fatty pancreas group (n = 223). The primary end point was the odds ratio (OR) for chronic pancreatitis associated with fatty pancreas, which was diagnosed using ultrasonography. We used a multiple logistic regression model to estimate the OR and the corresponding 95% confidence interval (CI). RESULTS: Ninety-two people were diagnosed with chronic pancreatitis, including both presumptive and definitive diagnoses. Twelve people were diagnosed with chronic pancreatitis by ultrasonography among the 223 patients with fatty pancreas, and 80 patients among 9710 were diagnosed with non-fatty pancreas. The crude OR was 6.85 (95% CI 3.68, 12.75), and the multiple adjusted OR was 3.96 (95% CI 2.04, 7.66). CONCLUSIONS Fat accumulation in the pancreas could be a risk factor for developing subclinical chronic pancreatitis.
Adipose Tissue ; diagnostic imaging ; pathology ; Adult ; Alcohol Drinking ; epidemiology ; Female ; Humans ; Japan ; epidemiology ; Life Style ; Logistic Models ; Male ; Middle Aged ; Pancreas ; diagnostic imaging ; pathology ; Pancreatitis, Chronic ; diagnosis ; epidemiology ; etiology ; Physical Examination ; Prospective Studies ; Risk Factors ; Smoking ; epidemiology

As a screening tool for detecting latent pre-locomotive syndrome (latent pre-LS) in women over the age of 40, measuring handgrip strength with a cut-off value of 26 kg was proposed in a previous report. However, this screening method missed 22% of latent pre-LS. It would be beneficial to screen almost persons with latent pre-LS in community pharmacies. In this study, it was investigated whether screening using the combination of measuring handgrip strength and the questionnaire, “Loco-check,” which was proposed by the Japanese Orthopaedic Association, improved the detection of latent pre-LS in the same group mentioned above. Combining only one of the “Loco-check” questions, “I cannot put on a pair of socks while standing on one leg,” with the measurement of handgrip strength with the cut-off value of 26 kg, the detection of latent pre-LS was increased to 90.2%. The odds ratio was 9.72 in logistic regression analysis. Using the combination of the measurement of handgrip strength and the response to one question is both rapid and convenient. Therefore, in this study, this screening combination is proposed to be a useful tool in community pharmacies for detecting early latent pre-LS.