We retrospectively investigated the prevalence of influenza virus type A infection and the efficacy of Kampo medicine as a prophylactic for handicapped residents at our social welfare institution, during the 2004/5 flu season. Upon studying a nationwide surveillance report for said season, we supposed that it had been difficult to prevent mass infection at our welfare institution with the usual preventive methods, because type B had prevailed for most of the season, and because of the differing type A (AH 3) antigenicity which prevailed late-season, for which there were no type A vaccines.43 of 90 (47.8%) residents given flu vaccinations twice, and 25 of 110 (22.7%) of staff members given flu vaccinations once contracted type A influenza between March and May of 2005. Interestingly, residents who had been administered Hozai for either short-term health problems or chronic disease, demonstrated a low influenza prevalence, there being a statistically significant difference (p<0.05) between our “Hozai” and “non-Hozai” groups. Furthermore Juzentaihoto, known to enhance immune function, seemed beneficial because of its low associated morbidity rate, and only 2 of 8 residents administered it contracted flu. No difference was observed, however, between generalized “Kampo treatment” and “non-Kampo treatment” groups.We consider that certain Kampo medicines may be useful for the prevention of influenza infection, in institutionalized handicapped residents with short-term health problems. Immunological enhancements, and the influence of Hozai are discussed here.
Medicine, Kampo ; Seasons ; Infection as complication of medical care ; Influenza ; Prophylactic

A 22-year old man was referred for mental retardation, refractory epilepsy, and chronic renal failure due to congenital anomalies of the kidney and urinary tract since he was an infant. Although hemodialysis was introduced both 3 years and 8 months ago, neither its appropriate safe management nor good quality of life were obtained, because of polyhydruria, psychogenic polydipsia, and his aggressive disruptive behavior in refusing any proper direction. After the fourth making of a shunt vessel with an artificial material, we gave him Orengedokuto to reduce his insomnia, itching, and other indefinite complaints.
As a result, his complaints and behaviors improved and he stopped taking too much water on the days before hemodialysis; which then began to work preferably with the proper amount of water exclusion. Moreover, we could reduce the amount of carbamazepine and methylphenidate hydrochloride he required. This case demonstrates that Orengedokuto may have an effect on the central nervous system to improve behavioral problems stemming from developmental disorders in children, or adolescents.

Introduction: Voriconazole (VRCZ) is a triazole antifungal agent for which therapeutic drug monitoring (TDM) is recommended. At Juntendo University Hospital, the VRCZ TDM implementation rate was 42% between January 2011 and October 2017. Here, we report that modifications to the hospital’s drug ordering system improved the implementation rate of VRCZ TDM.Method: In August 2018, the drug ordering system was modified so that a message appeared on the screen to notify clinicians of the need to monitor VRCZ blood concentrations and to recommend a date for sample collection. In addition, the laboratory orders for VRCZ levels were digitized. We compared two one-year periods before and after implementation of the modifications (August 2017 to July 2018 and August 2018 to July 2019) to verify the effect of the changes.Result: Results showed an increase in the TDM implementation rate: 12 patients (42.8%) received TDM before modification of the system, and 26 patients (92.9%) received TDM after modification of the system. Further, the rate of blood sampling at the recommended time point for estimating blood concentration (day 5-7 after the start of administration) improved after system modification, i.e., blood samples were collected from 18 patients (64.3%) at the steady state point. In contrast, blood samples were collected from only 6 patients (21.4%) before system modification. When blood concentrations deviated from the target range in patients who received TDM, clinicians took appropriate actions, such as reducing drug doses, prescribing drug holidays, or discontinuing medications.Conclusion: A system that provides information related to VRCZ blood concentration measurements can help clinicians provide patients with optimal pharmacotherapy.