The WHO reported the importance of IPE (Interprofessional Education) in order to implement team-based medicine smoothly. Some Japanese medical educational institutes presented their IPE programs, which involved real patients, but most IPE programs used scenario-based or standardized patients. Moreover, few reports showed IPE programs for diabetic patient education. We created a new program, called the "Diabetes education class IPE" . Participants were 2 medical, 4 nursing, 4 pharmacy, and 3 dietician students. The students experienced the planning and management of and reflection on diabetes education classes. As a result of reflection, the "Diabetes education class IPE" was viewed as a useful IPE program.

Keishibukuryogankayokuinin (KBGY) is a Kampo formulation that is well known as being suitable for patients with blood and water stagnation. In this study, we retrospectively investigated the efficacy of KBGY for tinnitus patients. The total number of patients was 9 (5 males, 4 females). The average age was 67 years (range : 54-81 years, the median age : 65 years). The progression of 9 patients was cure (1), amelioration (6), no change (2), and deterioration (0). The important pathophysiology of tinnitus in Kampo medicine includes blood stagnation and water stagnation. In these cases, KBGY can single-handedly improve both blood and water stagnation. We recommend KBGY for the treatment of tinnitus caused by the coexistence of blood and water stagnation.

Objective: The importance of occupational exposure control in cancer therapy is widely recognized, and measurement of anti-cancer drug exposure during preparation, as well as comprehensive measures, including administrative control, patients’ excrements, and environmental pollution, among others, are becoming important. The Osaka Women’s and Children’s Hospital introduced the closed system drug transfer device (CSTD) for administering anticancer drugs, and conducted consistent exposure measures from preparation to disposal. We simultaneously conducted an awareness survey on anti-cancer drug exposure measures for health care workers,observed the changes in their awareness and behavior, and examined the issues that constantly challenge anti-cancer drug exposure measures.Method: We surveyed doctors, nurses, and pharmacists who handle anticancer drugs belonging to the Osaka Women’s and Children’s Hospital from March 2018 to October 2018. The questionnaire was anonymous and was collected within one week after distribution. In the questionnaire survey, we obtained permission to present the contents on paper and orally.Results: The questionnaire response rate was approximately 70%. Following the training and introduction sessions, the participants had an improved understanding of Hazardous Drugs and CSTD. The introduction of the workshops on anti-cancer drug exposure measures and CSTD encouraged the nurses to reflect on the exposure measures and revisit the manuals on in-hospital treatment with anti-cancer drugs; however, there was little or no change in the behavior of the pharmacists.Discussion: Since nurses work primarily in the field of patient care, their awareness of anti-cancer drugs has gradually declined, and it was observed that procedures for exposure control were not being followed. In order to ensure that anti-cancer drug exposure measures are properly observed, pharmacists need to take initiatives and conduct in-hospital workshops once every six months. It is also necessary to educate the medical staff about electronic devices in order to ensure their easy participation in workshops and encourage e-learning.

A woman in her 60s was being treated for diabetes and hypertension but had impaired activities of daily living (ADL) due to severe obesity (150 kg). She was transported to the emergency department because of disturbance of consciousness in August 201X. Imaging findings showed decreased permeability of the whole right lung field. She was intubated and started on ceftriaxone plus levofloxacin for severe infection with respiratory failure. Erysipelothrix rhusiopathiae was detected in blood cultures, leading to a diagnosis of sepsis due to a large pressure ulcer on the posterior aspect of the thigh. We switched levofloxacin to clindamycin and continued medical treatment, and she was extubated on the 10th day of illness. However, type 2 respiratory failure was prolonged because of alveolar hypoventilation due to obesity and she required noninvasive positive pressure ventilation. Also, she had difficulty getting out of bed due to obesity, disuse syndrome, and pressure ulcer. Cooperation among staff from many professions, including respiratory nursing, intensive care nursing, wound, ostomy and continence nursing, physical therapy, and nutrition management, led to improvement of ADL and weight loss (to 109 kg), allowing her to be transferred out of the intensive care unit.