Nutritional support for patients who develop cancer is necessary to increase their food intake, which is often insufficient due to the adverse effects of anticancer drugs and radiation treatment. In December 2011, our center introduced Bocchiri meals for cancer patients to improve their quality of life and support ongoing treatment. In this study, we examined the efficacy of Bocchiri meals, which were developed to help increase the amount of food intake during cancer treatment. Target patients were those who could eat half or less than half of their daily required food intake, averaged over 3 days.Patients could order the meal 2 h before serving time and it was served at the temperature and amount that individual patients requested.We evaluated age, sex, main disease, use of anticancer drugs, radiation treatment, time taken to eat the Bocchiri meals, number of orders made, average energy intake before and after eating the Bocchiri meals, and rate of eating a Bocchiri Meal with a side menu order. Average energy intake was increased from 226.6±14.8 kcal with regular meals to 294.1±15.3 kcal with Bocchiri meals. Furthermore, a strong correlation was seen after the Bocchiri meals were introduced between the rate of eating Bocchiri meals with a side menu order and average energy intake. These results suggest that Bocchiri meals may be an effective supportive nutritional measure to enhance food intake among cancer patients.

Malignant psoas syndrome（MPS）is one of challenging cancer pain states, which is often refractory to conventional analgesic therapy. We report a case of a 67 years-old female patient suffering from left MPS caused by lumbar paravertebral malignant lymphoma. Tapentadol, a dual action analgesic, has relatively low affinity to mu-opioid receptor and provoke noradrenergic reuptake inhibition simultaneously. Neuropathic component is predominant in MPS. Tapentadol is reported to be a drug of choice for the treatment of neuropathic pain. Psoas compartment blockade is a choice of interventions to relieve severe thigh pain caused by a lesion of lumbar plexus which exists in a compartment between psoas and quadratus lumborum muscles. Pain and numbness in the affected left thigh region of the patient were well managed by opioid switching from oxycodone to tapentadol and supplemental psoas compartment blocks with a local anesthetic and dexamethasone. The activity of daily life and quality of life of the patient were dramatically improved. Tapentadol with psoas compartment blockade may be efficacious for the management of MPS.

Objective: The aim of this study was to investigate the palliative care for cancer patients provided by a long-term care unit. Methods: We retrospectively investigated the medical records of 194 patients who hospitalized in our long-term care unit between April 2010 and December 2014. The patients shared with a group of two, narcotic drugs non-use period (previous group; until March 2012) and narcotics use period (later group; in April 2012 or later), and it was compared with a background, hospitalization period, result on discharge, narcotic drug administration, symptom relief. And it was surveyed hospitalization dynamics of our palliative care unit for comparison. Result: Cancer patients were 16 (22%) in previous group of 74 patients and were 79 (66%) in later group of 120. The proportion of cancer patients in later group increased to three times (p<0.001). In later group, the average hospital stay was shortened to half (144 days, p<0.01) and the mortality discharge rates increased (78%, p<0.05). Narcotic drugs were administered to more than half (57%) of cancer patients in later group, and pain relief was significantly better. In the period of later group, number of hospitalized patients in palliative care unit was also increased. Conclusion: It was suggested that the long-term unit can perform palliative care for cancer patients in cooperation with the palliative care unit.

Introduction: The purpose of this study was to identify factors affecting the length of hospitalization of elderly patients with urinary tract infection (UTI) in an acute care hospital, where general practitioners treat the majority of them.Methods: Subjects were patients aged ≥ 65 years with UTI who were admitted to our hospital between April 2019 and March 2021. The primary endpoint was the length of hospital stay on an acute care ward. Factors associated with the primary endpoint were detected using logistic regression analysis with several explanatory variables (patients' baseline characteristics, laboratory findings, and interventions during hospitalization).Results: In total, 143 cases were eligible for analysis (88±7 years old, 37% male). Multivariate logistic regression analysis revealed that: Charlson Comorbidity Index ≥ 6, complex UTI with urologist's assessment, and the score of the Functional Oral Intake Scale (FOIS) on admission were significant factors correlated with the length of hospitalization (odds ratios: 5.07, 0.13, and 0.30, respectively).Conclusion: In older patients with UTI, CCI≥6, UTI without urologist's assessment, and a lower score of FOIS may prolong the length of stay in an acute care hospital.

This article describes the end of life of seven people with amyotrophic lateral sclerosis (ALS) under the care of a hospice. The reasons for admission to hospice were for the management of distressing symptoms and the support of families who were unable to continue care at home because of the increased burden of care and/or illness of families. The sufferings experienced by the patients with ALS included disability due to muscle weakness(100%), pain(100%), discomfort (100%), dyspnea (71%), difficulties in communication (71%), drooling (43%), insomnia (43%), loneliness (43%), swallowing difficulties (28%), clenching the mucosa inside the cheek (28%), anxiety (28%), the perception of being a burden to the family (28%), and concerns as to why they had developed ALS (28%). Opioid medication was effective in the management of dyspnea, pain and discomfort. The results showed that special attention should be paid to frequent changing of the patient's position during nursing care, including the passive movement of joints and massage. The use of communication aids was essential to allow people with ALS to communicate effectively and, together with support of joy of the patients and family, the quality of life could be improved. End of life care within a hospice is a useful alternative option for persons with ALS, extending hospice care in Japan from people with advanced cancer to other disease groups. Palliat Care Res 2010; 5(2): 137-143

PURPOSE: This retrospective cohort study was conducted to demonstrate how allocation of nurses specialized in HIV care influences clinical outcomes of antiretroviral therapy (ART) for people living with HIV (PLWH). METHODS: The medical records of 116 PLWH who started ART between January 2002 and December 2004 were analyzed. Occurrence of viral suppression and viral relapse after suppression achievement and their time from baseline were observed as clinical outcomes related to ART. Clinical outcomes were obtained from medical records between January 2002 and December 2006. PLWH were classified into two groups according to allocation (n = 95, nurse allocated group) or nonallocation (n = 21, nurse nonallocated group) of nurses specialized in HIV. RESULTS: Survival analysis showed that HIV viral load was suppressed more rapidly and continuously in nurse allocated group than nonallocated group (p < .0001). Viral relapse after suppression achievement occurred easily in nurse nonallocated group than allocated group (p = .003). CONCLUSIONS: The present findings demonstrated that the role of specialized nurses is critically important from the viewpoint of clinical outcome.
Achievement ; Antiretroviral Therapy, Highly Active ; Cohort Studies ; HIV ; HIV Infections ; Japan ; Medical Records ; Nursing Service, Hospital ; Recurrence ; Retrospective Studies ; Viral Load

It is assumed that keishikaryojutsubuto was first described in the Ho-ki medical text, and it has been used to target neuralgia and the arthritic pain. We experienced cases of Crohn's disease, endometriosis, post-operative rectal carcinoma, acute gastroenteritis and Meniere's disease successfully treated with keishikaryojutsubuto. When this formulation is administered, it might be important to keep in mind the definition of prescriptions for keishikashakuyakuto and shimbuto, or ryokeijutsukanto, as described in the Kokan-igaku text. In addition, this formulation might be applicable to various other diseases.
symptoms <1> ; Application, NOS ; Acute ; Pain ; Meniere's Disease

We report a case of neurogenic bladder that was successfully treated with hangebyakujutsutemmato. A 71-year-old Japanese male had difficulty in micturition because of a neurogenic bladder. We utilized hangebyakujutsutemmato on the assumption that he was suffered from qi deficiency, water retention, and qi stagnation. His symptoms disappeared with this therapy. Although kidney tonifying formulae, dampness-draining formulae, and blood stasis-resolving formulae are popular prescriptions for nerurogenic bladder, hangebyakujutsutemmato may be also effective for cases with qi deficiency, water retention, and qi stagnation.
Bladder, Neurogenic ; Treated with ; Water ; deficiency ; g <3>

OBJECTIVESThe purpose of this study was to assess the validity of the candidate indicators secretory immunoglobulin A (s-IgA) and sense of coherence (SOC) as predictors of threatened premature birth.

METHODSThis was a panel study conducted on women in their first and latter half of pregnancy during survey period. The survey period was from December 2005 to June 2006 and from December 2007 to June 2008. The women enrolled in the study were asked to complete the survey questionnaire and provide blood samples for the determinations of physiological indicators. The questionnaire consisted of questions related to the stress perception scale (SPS), SOC score as an indicator of modifiers of stress, demographic data, complications in a previous pregnancy, and the course of the current pregnancy. We used s-IgA and high-sensitivity C-reactive protein as a physiological stress indicator and a marker of infection, respectively. Seventy-two eligible subjects were included in the analysis.

RESULTSTwenty-eight (38.9%) subjects had undergone treatment for threatened premature birth, and 44 (61.1%) subjects had not. In the logistic analysis, we set the course of pregnancy as a dependent variable, and age, birth history, smoking habits, a history of miscarriage, premature birth or threatened premature birth, SPS, SOC, and s-IgA in the first half of pregnancy as independent variables. We found that low serum s-IgA levels and low SOC scores in the first half of pregnancy were associated with threatened premature birth.

CONCLUSIONSOur results suggest that low serum s-IgA level and SOC score at an early gestational stage are significant indicators for a threatened premature birth.

OBJECTIVEIn this study, we evaluated postpartum stress using a postpartum depression scale and by measuring the level of a stress-related substance, to clarify the relationship between the stresscoping capabilities of women in the final stage of pregnancy and their postpartum stress reactions.

METHODSBetween April 2004 and October 2004, 54 women participated in a question naire survey and the measurement of their secretory immunoglobulin A (s-IgA) level as a stress-related substance two times in the final stage of their pregnancy (prepartum) and in their early puerperium (postpartum) was carried out. The questionnaire used in the prepartum stage included the following parameters: "basic features", "Sense of Coherence (SOC)" and "Japanese version of the self-assessment depression scale" of Zung. The questionnaire employed in the postpartum stage included the following parameters: "course of delivery", "Self-evaluation of delivery experience", and "Postpartum depression scale".

RESULTSThe depression score was higher and the s-IgA level was lower in the low-SOC score group than in the high-SOC score group, indicating that stress reactions were more intense in the low-SOC score group.

CONCLUSIONIt was revealed that stress reactions were more intense for women with a low SOC score. Moreover, the finding of a relationship between the low SOC score in the prepartum stage and depressive tendency suggests that women who are likely to develop depressive tendency can be predicted in the prepartum stage, and the significance of measuring SOC in the prepartum stage is thus suggested.