Introduction : The purpose of this study was to clarify the antimicrobial susceptibility of Haemophilus influenzae in central Tokyo over a ten-year period.
Methods : We investigated the susceptibility of Haemophilus influenzae isolated in Tokyo Saiseikai Central Hospital for 10 years from 2004 through 2013.
Results : Significant increases in the proportion of strains resistant to ampicillin, ampicillin / sulbactam and cefditoren pivoxil were noted for some years in comparison to the first year studied. There were no significant changes in the susceptibility to levofloxacin and clarithromycin. The proportion of strains resistant to ampicillin and cefditoren pivoxil showed statistically significant increases during the study period. The proportion of the strains resistant to ampicillin / sulbactam isolated from children was greater than from adults for every year studied. Levofloxacin resistant strains were isolated only from adults. The proportion of strains resistant to clarithromycin were about 1% in Japanese national surveillance data, but the proportions in this study were over 9%.
Conclusion : Over a ten-year period in central Tokyo, Haemophilus influenzae strains resistant to ampicillin and cefditoren pivoxil increased. Strains resistant to clarithromycin occurred at a higher rate than nationally.

Objective:Marketing specialists (MSs) from pharmaceutical wholesalers might shore up post-marketing surveillance (PMS) by pharmaceutical manufacturers. The purposes of this study were as follows: to research problems in PMS found by market specialists, to find solutions for these problems, and motivating MSs to work on PMS. Methods: We conducted a workshop with 12 MSs, who were already working on PMS operations. Participants were divided into three groups. Each group discussed problems with their PMS operations using the KJ method, discussed the potential solutions for the problems, and finally presented them in a plenary debate session. Questionnaire surveys were conducted for the participants before, immediately after, and 6 months after the workshop. Results: This workshop revealed two crucial and urgent problems on PMS faced by MSs: lack of feedbacks to clinical site and lack of publicity of the significance of PMS by MSs. Several solutions were suggested: browsing system of collected information, publication of the stages of improvement in pharmaceutical preparations and packaging, and distributing leaflets about PMS by MSs. In addition, this workshop conferred a positive influence on the participants: in the post-workshop questionnaires, most of the participants answered that they could well understand the problems (92%) and the solutions (75%) on PMS, and that they could improve their attitudes toward PMS operations (83%). . Conclusion: This workshop was quite effective for most of the participants in searching the problems, considering the solutions, and improving their attitudes. Organization of several such workshops might result in better PMS by MSs.

Regional cooperation in palliative medicine involves multidisciplinary team care. It is very important for cancer patients to choose an appropriate place of stay during their end-of-life period. As the Nagoya Memorial Hospital does not have a palliative care ward, collaborating with other facilities offering palliative care and home care becomes pivotal. Therefore the Higashi-Nagoya home care social gathering was organized to improve communication and cooperation among regional health care professionals. Through discussions during this social gathering, the communication tools for cooperation in palliative care were outlined in November, 2015. We reviewed the outcome of 35 patients referred from our hospital using the communication tools for cooperation in palliative care: 25 patients were referred to chronic care hospitals including palliative care facilities, and 10 patients received palliative care at home; 23 died in the palliative care ward, 6 died at home, and 4 died at our hospital. A questionnaire survey conducted among the community health care professionals revealed that the introduction of this tool would be useful in providing accurate information on the prognosis of patients, level of understanding between the patients and their family, and patients’ views on life and death. Using the communication tool for communication would contribute to realizing seamless palliative care in the region surrounding our hospital, which would in turn lead to local team work and shared responsibilities to provide optimal palliative care.