Purpose: To clarify intervention methods used by medical professionals in clinical situations and their effects on the health literacy of patients.Method: Reports on randomized controlled trials for the health literacy of patients were collected from the electronic database. The reports were then evaluated using qualitative systematic reviews conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.Result: On examination of the effects by intervention methods, we found that many reports concluded an improvement in health literacy by patients by "only the distribution of handouts". Moreover, many reports also noted improved "adherence for health behavior" by patients following the "distribution of handouts and explanation by medical professionals". Furthermore, improved "health literacy" by "one-way intervention from medical professionals to patients" and "two-way intervention by both medical professionals and patients" was reported.Conclusion: Based on this study, it may be possible to provide information considering individuality when the medical professional provides an explanation to the patient in addition to giving handouts. Improved disorder comprehension and self-management skills are expected when the medical professional appropriately confirms the patient's comprehension level.

Purpose: The purpose of this study was to acquire integrated views from previous studies on what interventions by rehabilitation specialists have led to the reduction of the care burden for stroke survivors' families.Method: Reported randomized controlled trials concerning interventions for the care burden of stroke survivors' families by rehabilitation specialists were extracted from two electronic databases, and their content was assessed by a systematic review.Results: Among the 11 analyzed studies, no studies focused on the stroke survivors' families. Studies reporting a reduction in the care burden were those comparing the presence of botulinum therapy and those comparing occupational therapy and non-intervention.There were no significant differences in the care burden for stroke survivors' families between the interventions by rehabilitation specialists and standard rehabilitation.Conclusion: Interventions for stroke survivor's families by rehabilitation specialists do not reduce the care burden in comparison with standard care.

Objective: In our country, the measure for the spread of the generic has been introduced over several-time as part of the moderation in health care cost plan.  However, not having related to an enough spread unlike Europe and America yet is a current state.  Then, we investigated from the view point of patients.  A detailed examination was performed for the acknowledgment level and attitude toward the generic drug.
Design and Method: The questionnaire survey was performed for the patient who used the community pharmacy for dispensing prescription.  The investigation was performed for two weeks (June and July, 2008) at the 50 drugstores in Hokkaido.  The patient attribute, source of information, and kind of the taking medicine were examined as a factor to affect decision making for generic drug substitution.
Result: The main results are as follows.  The patients who did not know generic drugs accounted 52% of the total and the patients who did not know the words called generic drugs was 16%.  This result shows that the degree of the recognition about generic drugs at that time was still low.  The information source for the patients who learned generic drugs were articles of the newspaper, a TV program, and advertising with accounted 52% of the total.  Also, the patients who prefer generic drugs in the future were 64%.  In the relationships between presence of wish for generic drugs and the source of information, the case of from the doctor, was significant (p<0.05) and the case from the pharmacist showed the tendencies of statistical significance (p=0.076).
Conclusion: From the viewpoint of medicine costs restraint in our country, it seems that the pharmacist contributes for the patient’s generic drugs selection expected positively.

Objective: Doping is strongly prohibited in sports.  Sports pharmacist was born in 2010 in Japan, and the anti-doping activity is expected.  On the other hand, doping by arising from a lack of knowledge about prohibited substances in athletes, so-called “unwilling doping” is developing into a social issue.  In this study, we investigated the percentage of prohibited substances in all drugs and prescriptions in a general hospital, to collect information to prevent an unwilling doping.
Methods: We constructed system to extract the drugs corresponding to prohibited substances in the prescription order entry system in Otaru Municipal Hospital, and we analyzed 3,306 prescriptions of 10 to 59 years old patients, from July to September 2010.
Results: Thirteen point five percent of our hospital drugs met definition of the prohibited substance.  The number of prescriptions including prohibited substance(s) was 350 (10.6%), and its category was different from each age-group and clinical department.
Consideration: Because prohibited substances are included in approximately 10% of prescriptions, athletes are exposed to danger of becoming an unwilling doping.  Pharmacist should be well informed about prohibited substances to prevent athletes from unwilling doping.  And they should provide information promptly and adequately for athletes.

A 72-year-old woman who had undergone three atrial catheter ablations for chronic atrial fibrillation was referred for surgical treatment for severe atrial functional mitral regurgitation. She suffered not only dyspnea but also dysphagia due to esophagus compression by a giant left atrium 15×12×11 centimeters in size. In her surgery, mitral valve repair using a 36-millimeter artificial ring, tricuspid annuloplasty and resection of the left atrial appendage were performed. In addition, the posterior, lateral, and superior wall of left atrium, 4 centimeters in width, was extensively resected to reduce left atrial volume. Postoperative echocardiography showed a decrease in both mitral and tricuspid regurgitation to trivial levels as well as an improvement in left ventricular diastolic function. Postoperatively her dysphagia disappeared and NYHA class improved from III to I. In her chest X ray, the cardiothoracic ratio fell from 80% to 56%, and the tracheal bifurcation angle decreased from 110 to 90 degrees. In a patient with a giant left atrium due to atrial functional mitral regurgitation, a favorable clinical outcome resulted from double valve repair combined with extensive left atrial resection.

A 20-year-old woman had a tendency of belching from a young age. She began to realize that she might have excessive belching compared to other people for the past two years. She was prescribed some medicines to improve gastrointestinal function by some physicians, but her symptoms did not resolve. Aerophagia was suspected as forceful belching tends to occur soon after eating or drinking. Incidentally, ihon is a condition in which one vomits food half a day after the ingestion due to the malfunction of the digestive system. I considered her symptoms as ihon and prescribed bukuryotakushato, and her symptoms improved. This case report indicated that ihon could be defined as a symptom of forceful regurgitation of food or air, regardless of the timing after meals.

BACKGROUND: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, people need to practice social distancing in order to protect themselves from SARS-CoV-2 infection. In such stressful situations, remote cardiac rehabilitation (CR) might be a viable alternative to the outpatient CR program. METHODS: We prospectively investigated patients hospitalized for heart failure (HF) with a left ventricular ejection fraction of < 50%. As for patients who participated in the remote CR program, telephone support was provided by cardiologists and nurses who specialized in HF every 2 weeks after discharge. The emergency readmission rate within 30 days of discharge was compared among the outpatient CR, remote CR, and non-CR groups, and the EQ-5D score was compared between the outpatient CR and remote CR groups. RESULTS: The participation rate of HF patients in our remote CR program elevated during the COVID-19 pandemic. As observed in the outpatient CR group (n = 69), the emergency readmission rate within 30 days of discharge was lower in the remote CR group (n = 30) than in the non-CR group (n = 137) (P = 0.02). The EQ-5D score was higher in the remote CR group than in the outpatient CR group (P = 0.03) 30 days after discharge. CONCLUSIONS Remote CR is as effective as outpatient CR for improving the short-term prognosis of patients hospitalized for heart failure post-discharge. This suggests that the remote CR program can be provided as a good alternative to the outpatient CR program.
Aged ; Betacoronavirus ; Cardiac Rehabilitation ; methods ; Coronavirus Infections ; epidemiology ; Heart Failure ; rehabilitation ; Humans ; Japan ; Middle Aged ; Monitoring, Ambulatory ; Pandemics ; Pneumonia, Viral ; epidemiology ; Prospective Studies ; Self Care ; Telemedicine ; methods ; Telephone

Objective: Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is important due to concerns regarding infectivity, transmissibility, immune evasion and disease severity. We evaluated the temporal and regional replacement of previous SARS-CoV-2 variants by the emergent strains, Alpha and Delta. Methods: We obtained the results of polymerase chain reaction screening tests for variants conducted in multiple commercial laboratories. Assuming that all previous strains would be replaced by one variant, the new variant detection rate was estimated by fitting a logistic growth model. We estimated the transmission advantage of each new variant over the pre-existing virus strains. Results: The variant with the N501Y mutation was first identified in the Kinki region in early February 2021, and by early May, it had replaced more than 90% of the previous strains. The variant with the L452R mutation was first detected in the Kanto-Koshin region in mid-May, and by early August, it comprised more than 90% of the circulating strains. Compared with pre-existing strains, the variant with the N501Y mutation showed transmission advantages of 48.2% and 40.3% in the Kanto-Koshin and Kinki regions, respectively, while the variant with the L452R mutation showed transmission advantages of 60.1% and 71.9%, respectively. Discussion In Japan, Alpha and Delta variants displayed regional differences in the replacement timing and their relative transmission advantages. Our method is efficient in monitoring and estimating changes in the proportion of variant strains in a timely manner in each region.

Utilizing data presented in the article by Miyashita et al., we illustrate the importance of testing data when assessing surveillance data. Accounting for the number of tests (denominator) and positivity (proportion of tests positive for a specific pathogen(s)) improves data interpretation in ways not possible from numerator case data alone.