The medical insurance system was reformed in 2008. A new program was introduced to detect metabolic syndrome in the early stages with the aim of reducing lifestyle-related diseases such as diabetes and hypertension, and the specific medical examination and specific health instruction became incumbent on the medical insurers. The primary purpose of the medical examination was not only to discover metabolic diseases but also to provide the people an opportunity to reconsider their lifestyle. The specific health instruction was to raise health consciousness. Our hospital started the specific medical examination in the first year. Based on the screening outcome data, the specific health instruction, the specific health instruction was implemented.　　This year marks the fifth anniversary of the introduction of the new medical insurance system. We investigated how the effect of the health instruction lasted based on the results of the medical examination that we carried out in 2012. The average weight decreased 1.0 kg (P<0.001) and the mean girth of the abdomen decreased 1.5 cm (P<0.001). Those who successfully lost weight and maintained that success accounted for 60%, as compared with women’s figure of 66% for women. There were people who lost weight temporarily, but regained all or more than they lost in four years. Compared to women, men showed a strong tendency to regain weight lost. The level of the specific health instruction has been improved. The effects of the health instruction would last longer. However, to ward off rebound weight gain, it is necessary for us to keep careful watch over area residents and work out more effective prophylactic measures.

With aging of inpatients, the prevention of falls in old people is an important task nurses have to take upon themselves. In our hospital, we have been tackling the task in earnest by utilizing a fall prevention assessment score sheet. Our efforts have resulted in changes in the attitude of nurses as shown by a survey. (1) By working on the nursing plan with use of the fall prevention assessment score sheet, nurses have become alert to risk factors for falling. (2) They have realized that assistance suited to the needs of each patient is vital and that collaboration between patients, their families and hospital staff contributes to the prevention of falls greatly. (3) The use of an intervention manual has made it easy for nurses to cope with falls and consequent injury. (4) To share information of every factor for falling among the nursing staff has added greatly to the prevention of the recurrence of the fall.
Prevention ; Fall, NOS ; Surveys ; Attitude ; Knowledge acquisition using a method of assessment

OBJECTIVESThe association of blood pressure and levels of serum lipids, liver enzymes, blood glucose and aldehyde dehydrogenase 2 (ALDH2) with drinking habit was examined in Japanese men.

METHODSThe subjects were 264 men aged 39 to 80 years who were classified into the ALDH2 deficiency or sufficiency group using the ethanol patch test and the Tokyo University ALDH2 Phenotype Screening Test. A self-administered questionnaire including drinking habit was used. Blood pressure and the levels of biochemical markers in groups with ALDH2 sufficiency, ALDH2 deficiency and drinking habit were compared using multiple regression models for adjusting age, smoking habit, physical exercising habit and body mass index.

RESULTSThe levels of serum high-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (γ-GTP) were significantly higher in current drinkers of 20 g of ethanol or more per day than in nondrinkers of the ALDH2 sufficiency group. The levels of serum AST and γ-GTP in current drinkers of 20 g of ethanol or more per day, and fasting blood sugar in current drinkers of less than 20 g of ethanol per day were significantly higher than those in nondrinkers of the ALDH2 deficiency group.

CONCLUSIONSThese results suggest that alcohol consumption increases the levels of serum lipids and liver enzymes in ALDH2-sufficient individuals and liver enzymes and blood glucose levels in ALDH2-deficient individuals.

A 67-year-old man with Stage IV gastric cancer (cT3N2M1) received chemotherapy. However, he had progressive disease and then, received palliative care. One day, he was admitted for difficulty in body movement. He had severe anemia (Hb: 3.4 g/dl) caused by tumor bleeding and needed frequent blood transfusions. Palliative radiotherapy (RT) was conducted to control the bleeding. However, hemostasis was not achieved despite daily palliative RT and blood transfusions. Gastrointestinal endoscopy showed oozing blood from gastric cancer and his Hb levels dropped to 2.8 g/dl. Transcatheter arterial embolization (TAE) with gelatin sponge was performed as salvage therapy. TAE was effective and his Hb levels improved to 8.0 g/dl, and he was discharged from the hospital. RT is an effective modality for gastric bleeding control in gastric cancer. However, salvage therapy is sometimes needed but difficult to conduct. TAE was effective salvage therapy in this case.