Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

Introduction: Kameda Family Clinic Tateyama (hereafter referred to as "the clinic" ) has been providing antenatal care by family physicians in collaboration with the Department of Obstetrics and Gynecology of Kameda General Hospital (hereafter referred to as "the main hospital" ) since 2006, but the scope of the program was limited to low-risk pregnant women up to 34 weeks of pregnancy. The program was expanded to include some high-risk pregnant women and full-term pregnant women. We conducted a retrospective study to determine how much the burden of hospital visits by pregnant women was reduced.Methods: We compared the actual situation of antenatal checkups with that assumed in the management before 2021, and analyzed the reduced number of visits to the main hospital and the total distance of visits to the main hospital.Results: Twenty-seven pregnant women were included in the study, and the median number of visits to the main hospital was reduced by 3 visits and the median distance of the main hospital visits was reduced by 183.6 km. In the high-risk group, the median number of visits to the main hospital was reduced by 5.5 times, and the median distance of visits was reduced by 257.6 km.Conclusion: Expansion of antenatal checkups using ICT technology safely reduced the distance of hospital visits for pregnant women.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.

Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Breast neoplasm screen NOS ; Clinical ; benefits ; Awareness ; Surveys

BACKGROUNDMultislice helical computed tomography (MSCT) has been used to depict coronary anatomy noninvasively, and proved useful for evaluating ventricular function. The aim of our study was to assess the accuracy of ventricular volume as measured by MSCT.

METHODSFourteen human left ventricular (LV) and 15 right ventricular (RV) casts were scanned by MSCT. A series of LV and RV short-axis images were reconstructed later with slice thickness of 2.0 mm, 3.5 mm, 5.0 mm, 7.0 mm, and 10.0 mm. Ventricular volume was calculated by the multislice tomographic Simpson's method. True LV and RV cast volumes were determined by water displacement.

RESULTSBoth calculated LV and RV volumes correlated highly with the corresponding true volumes (all r >0.95, P <0.01). But with slice thickness from 2.0 mm to 10.0 mm, MSCT scanning overestimated the corresponding true volume by (3.21 +/- 5.95) ml to (12.58 +/- 8.56) ml for LV and (10.22 +/- 8.45) ml to (23.91 +/- 12.24) ml for RV (all P <0.01). There was a very high correlation between the overestimation and the selected slice thickness for both LV and RV volume measurements (r=0.998 and 0.996, P <0.01, respectively). However, when slice thickness was reduced to 5.0 mm, the overestimation for both LV and RV volume measurements became nonsignificant for slice thickness from 2.0 mm to 5.0 mm.

CONCLUSIONSBoth LV and RV volumes can be accurately estimated by MSCT. Thinner slice has more accurate calculated volume. However, 5.0 mm slice thickness is thin enough for an accurate measurement of LV or RV volume.

Adolescent ; Adult ; Aged ; Cardiac Volume ; Child ; Child, Preschool ; Female ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

BACKGROUND: Hepatocyte growth factor (HGF) may act as a possible biochemical index for vascular damage, although evidence for the association between HGF and carotid intima-media thickness (CIMT) is limited. Since both HGF and circulating CD34-positive cells play an important role in endothelial repair, circulating CD34-positive cell levels may influence the association between HGF and CIMT. METHODS: We conducted a cross-sectional study of 269 elderly Japanese men aged 60-69 years who had undertaken an annual medical checkup from 2014 to 2015. RESULTS: The median value for circulating CD34-positive cells was 0.93 cells/μL. Among the study population, 135 men showed low circulating CD34-positive cell levels (≤ 0.93 cells/μL). By multivariable linear regression analysis, HGF was found to be significantly positively associated with CIMT only to participants with low circulating CD34-positive cell levels, with a multi-adjusted β of 0.26 (p = 0.005) and 0.002 (0.986) for low and high circulating CD34-positive cell levels, respectively. In addition, a significant interaction was observed between HGF and circulating CD34-positive cell levels (low and high) on CIMT (multivariable p value of 0.049). A positive association exists between HGF and CIMT in elderly Japanese men, limited to participants with low circulating CD34-positive cell levels. CONCLUSION A positive association exists between HGF and CIMT in community-dwelling elderly Japanese men, which is limited to participants with low numbers of circulating CD34-positive cells. Our findings indicate that circulating CD34-positive cell levels could determine the influence of HGF on CIMT in elderly Japanese men.
Aged ; Antigens, CD34 ; blood ; Biomarkers ; blood ; Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Hepatocyte Growth Factor ; metabolism ; Humans ; Japan ; Male ; Middle Aged