1.Prevalence of Complementary and Alternative Medicine Use in Ambulatory Patients with Urologic Disorders
Akiko MARUTANI ; Sachie MATUKI ; Rie HATTA ; Yoshie SAITO ; Tae HASHIMOTO ; Kazumi MIZUNO ; Hiromi TAKEUCHI ; Shizue TOMITA ; Satoshi OHNO ; Kazuto KOMATSU ; Mikio NAMIKI
Japanese Journal of Complementary and Alternative Medicine 2005;2(1):67-73
Objective: The prevalence of complementary and alternative medicine (CAM) in patients with various urologic disorders is unknown. We conducted the survey to determine the prevalence of CAM use in ambulatory patients.
Methods: We distributed questionnaires to 331 ambulatory patients with various urologic disorders in our department from March 10 to 31, 2004.
Results: One in third (30.5%) patients reported the use of at least one CAM. Patient age and gender were not associated with the frequency of the use of CAM. Although not statistically significant, patients with malignant disease showed a higher frequency of CAM use compared with patients with benign disease; 36.2% vs 27.0%, P=0.08. Among the CAM users, only 16 patients (15.8%) informed health care staff of their CAM use.
Conclusion: This result shows the current situation of CAM use in patients with urologic disorders. Because of the high prevalence, health care professionals should ask about patients' use of CAM.
2.Adrenal Venous Sampling for Subtype Diagnosis of Primary Hyperaldosteronism
Mitsuhide NARUSE ; Akiyo TANABE ; Koichi YAMAMOTO ; Hiromi RAKUGI ; Mitsuhiro KOMETANI ; Takashi YONEDA ; Hiroki KOBAYASHI ; Masanori ABE ; Youichi OHNO ; Nobuya INAGAKI ; Shoichiro IZAWA ; Masakatsu SONE
Endocrinology and Metabolism 2021;36(5):965-973
Adrenal venous sampling (AVS) is the key procedure for lateralization of primary hyperaldosteronism (PA) before surgery. Identification of the adrenal veins using computed tomography (CT) and intraoperative cortisol assay facilitates the success of catheterization. Although administration of adrenocorticotropic hormone (ACTH) has benefits such as improving the success rate, some unilateral cases could be falsely diagnosed as bilateral. Selectivity index of 5 with ACTH stimulation to assess the selectivity of catheterization and lateralization index (LI) >4 with ACTH stimulation for unilateral diagnosis is used in many centers. Co-secretion of cortisol from the tumor potentially affects the lateralization by the LI. Patients aged <35 years with hypokalemia, marked aldosterone excess, and unilateral adrenal nodule on CT have a higher probability of unilateral disease. Patients with normokalemia, mild aldosterone excess, and no adrenal tumor on CT have a higher probability of bilateral disease. Although no methods have 100% specificity for subtype diagnosis that would allow bypassing AVS, prediction of the subtype should be considered when recommending AVS to patients. Methodological standardization and strict indication improve diagnostic quality of AVS. Development of non-invasive imaging and biochemical markers will drive a paradigm shift in the clinical practice of PA.
3.The State of Peer Support in Designated Cancer Care Hospitals during the COVID-19 Pandemic
Hiromi OHNO ; Hirokazu KOMATSU ; Hiroko MAKITA
Palliative Care Research 2025;20(1):63-69
Objective: To investigate an impact of the new coronavirus infection on cancer peer support in hospitals. Methods: A 14-item, self-administered, unannounced questionnaire was administered at the consultation and support centers of Designated Cancer Care Hospitals from February 16, 2023, to March 17, 2023. Results: Of the 451 hospitals, 220 responded (48% response rate). In the aftermath of the COVID-19 pandemic, 89% of hospitals suspended patients support and 36% continued to do so. The following characteristics of the pandemic’s impact were identified: (1) stagnation of peer support, (2) introduction of online support, and (3) the need to develop hybrid support activities and acquire online support response skills. Before the COVID-19 pandemic, the operational structure of peer support was already facing challenges. Conclusion: This study suggests the need to establish an operational system for in-hospital peer support, including the use of the new online system introduced during the COVID-19 pandemic.