1.Characteristics of Keio University Hospital's Kampo Clinic Judging from the First Visit Patients
Ko NISHIMURA ; Hirotaka MAESHIMA ; Akihiko ARANAMI ; Kako WATANABE ; Motoko HUKUZAWA ; Koichi ISHII ; Tetsuo AKIBA ; Kenji WATANABE
Kampo Medicine 2007;58(5):867-870
Background : Since 2002, Keio University Hospital's Kampo Clinic has promoted itself actively through the media, public presentations, faculty outreach and an internet home page. However, the relative value of these promotions is unknown. Additionally, the range and prevalence of presenting concerns, and the ages and the gender ratio of the patients served at Keio is unknown.Objective and Methods : To better understand and better serve the patients, the medical charts of every new patient who presented to Keio University Hospital's Kampo Clinic from November 2004 to November 2005 (n=791) were retrospectively analyzed for 1) referral source, 2) age, 3) gender, and, 4) disease category.Results : The internet webpage was by far the best source of new patient referrals. The out-of-hospital referral rate to the clinic was remarkably low. Women exceeded men by a 3 : 1 ratio. Most women were in their thirties but male patients were fairly evenly distributed across the age spectrum. Patients under 16 and over 70 were gender-balanced. The vast majority of patients presented with general medicine/pediatric, dermatological or gynecological problems.Conclusion : A patient-oriented internet home page provides a good source of new patient referrals. Given the low rate of referrals from outside hospitals and physicians, additional outreach directed at internal medicine, dermatology or obstetrics/gynecology physicians appears warranted.
Clinic
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Hospitals
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Medicine, Kampo
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seconds
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Universities
2.Survey of the Use of Kampo Medicine at the Kampo Clinic
Nobutomo IKARASHI ; Kiyomi ITO ; Takayoshi KIMURA ; Tetsuo AKIBA ; Yoshifumi IRIE ; Kako WATANABE ; Motoko FUKUZAWA ; Hirokazu ISHII ; Kenji WATANABE ; Kiyoshi SUGIYAMA
Kampo Medicine 2009;60(4):435-442
Kampo medicines have been used for treatment by an increasing number of doctors in recent years, and are becoming more frequently prescribed in combination with Western drugs. In the present study, we conducted a questionnaire of outpatients at the Kampo Clinic of Keio University Hospital in order to determine their perceptions and compliance regarding Kampo medicines.Ninety eight percent of patients used Kampo medicines in granular form, and approximately 30% of these patients reported difficulty in taking medicine due to reasons such as “bad taste”. Sixty percent of patients used Kampo medicines three times daily. Patients most often forgot to take afternoon doses, and so desired doses once daily. Furthermore, the same number of patients preferred Kampo medicines in tablet form as those who preferred Kampo medicines in granular form.The present findings clarified patients' perceptions toward Kampo medicines. Doctors and pharmacists must provide suitable treatment for patients by recognizing their perceptions of Kampo medicines.
Medicine, Kampo
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Clinic
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Use of
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percent
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therapeutic aspects
3.Persistent Nocturnal Enuresis in Adulthood Effectively Treated Using Kampo Medicine : A Case Report
Mayumi TAMADA ; Kako WATANABE ; Shin-ichi MURAMATSU
Kampo Medicine 2023;74(1):54-59
Here, we report a case of nocturnal enuresis persisting into adulthood treated with Kampo medicine. A 21-year-old woman had a history of nocturnal enuresis every night during childhood and once every 2-3 nights during school age. Although the frequency of urinary incontinence decreased to 1-2 times/week at 19 years of age, nocturnal enuresis persisted into adulthood. She was diagnosed with mild strain of the rectus abdominis muscles and palpable abdominal aortic pulsation above the umbilicus, and keishikaryukotsuboreito (decoction) therapy was initiated. She did not experience urinary incontinence at night for 3 weeks, except for one episode immediately after treatment commencement. She tended to urinate only 4 times from the time she awoke until bedtime ; therefore, we added a small amount of goreisan to her treatment regimen to increase the urinary output and daytime frequency of urination. The frequency of urination increased from 4 to 7 times and stabilized. We discontinued goreisan administration 2 months later, and keishikaryukotsuboreito monotherapy was continued. We did not observe recurrent nocturnal enuresis and, therefore, switched the decoction to an extract. After the symptom stabilized, the dosage of keishikaryukotsuboreito was reduced by half. Nocturnal enuresis occurred only once when the patient missed a dose for 3 consecutive days but did not recur for over 4 months after strict adherence to medication. This case report highlights the role of Kampo therapy as an effective therapeutic option for nocturnal enuresis persisting into adulthood.
4.The Effect of Fan Therapy for Dyspnea in Patients with Chronic Progressive Disease: Systematic Review and Meta-analysis
Jun KAKO ; Yoichi NAKAMURA ; Tomohiro NISHI ; Yusuke TAKAGI ; Yoshinobu MATSUDA ; Hiroaki WATANABE ; Yoko KASAHARA ; Sho GOYA ; Hiroyuki KOHARA ; Masanori MORI ; Takashi YAMAGUCHI
Palliative Care Research 2022;17(1):33-42
Objective: To evaluate the efficacy of fan therapy for the relief of dyspnea in patients with chronic progressive disease. Methods: A systematic electronic database search of all available articles published before October 23, 2019 was conducted using Ichushi-Web of the Japan Medical Abstract Society databases, CENTRAL, EMBASE, and MEDLINE. In addition, a hand-search for updates was performed using PubMed on June 30, 2020 and December 7, 2021. The inclusion criteria were: 1) any RCTs comparing the effect of fan therapy with any other intervention, and 2) patients aged ≥18 years. Exclusion criteria were: 1) duplicate references, and 2) conference presentations. Results: We identified 110 studies, of which 10 met our criteria for inclusion. Finally, five studies were used in the meta-analysis. Fan therapy significantly improved dyspnea in patients with chronic progressive disease compared to control groups with a standardized mean difference of −1.43 (95% confidence interval: −2.70 to −0.17, I2=94%, p<0.0001). Conclusion: Fan therapy was found to be effective in reducing dyspnea in chronic progressive disease.
5.The Effect of High-flow Nasal Cannula Oxygen for Dyspnea in Patients with Advanced Disease: Systematic Review
Sho GOYA ; Yasushi NAKANO ; Hiroaki TSUKUURA ; Yusuke TAKAGI ; Hiroaki WATANABE ; Yoshinobu MATSUDA ; Jun KAKO ; Yoko KASAHARA ; Hiroyuki KOHARA ; Masanori MORI ; Takeo NAKAYAMA ; Takashi YAMAGUCHI
Palliative Care Research 2023;18(4):261-269
Objective: To evaluate the efficacy of high-flow nasal cannula oxygen (HFNC) for dyspnea in patients with advanced disease. Methods: A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Ichu-shi Web. Inclusion criteria were: 1) randomized controlled trials evaluating the effect of HFNC on dyspnea; 2) aged 18 years or older with advanced disease with hypoxemia; 3) control group was conventional oxygen therapy or noninvasive positive pressure ventilation. Exclusion criteria were: 1) patients in intensive care unit, 2) weaning from ventilator. Results: Six studies (4 from database searches, and 2 from hand searches) were included. In the 2 studies evaluating short-term intervention, one showed HFNC was more efficacious, and the other conventional oxygen was more efficacious. In the 2 studies evaluating long-term interventions: one showed HFNC was more efficacious, and the other showed no significant difference. In the 2 studies evaluating the intervention during exercise, one showed HFNC was more efficacious, and the other showed no significant difference. Conclusion: HFNC may be effective for dyspnea in patients with advanced disease associated with hypoxemia.