In the areas of home medical care and self-medication, the role of the pharmacist is growing, partly as a result of Japan’s aging society and the need to reduce medical costs. In response, the Kinki University Faculty of Pharmacy implemented a physical assessment practical training seminar in order to improve the physical assessment skills of practicing pharmacists. A series of questionnaires were conducted among pharmacists to investigate their perceptions of physical assessment practical training seminars. The results of the questionnaires were analyzed using Customer Satisfaction (CS) analysis and text mining. Based on a 5-point scale (1-low∼5-high), questionnaires revealed satisfaction for physical assessment practical training seminars was 4.6±0.6 (Ave.±S.D.). CS analysis revealed that the items “lectures” and “case seminars” had the highest level of satisfaction. However, items showing low levels of satisfaction were “auscultation of respiratory sounds” and “SBAR (Situation, Background, Assessment, Recommendation).” Results of text mining suggested a relationship between “physical assessment” and “difficult”. Analysis of the questionnaires showed a high level satisfaction with physical assessment practical training seminars, notably physical assessment practice methods. However, CS analysis and text mining indicate the finer techniques of physical assessment were difficult to acquire.

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

Endoscopic ultrasonography (EUS) combines endoscopy and intraluminal ultrasonography, and allows imaging with a high-frequency transducer over a short distance to generate high-resolution ultrasonographic images. EUS is now a widely accepted modality for diagnosing pancreatobiliary diseases. EUS-guided fine-needle aspiration (EUS-FNA) using a curved linear-array echoendoscope was initially described more than 20 years ago, and since then many researchers have expanded its indications to sample diverse lesions and have also used it for various therapeutic purposes. EUS-guided biliary drainage (EUS-BD) is one of the therapeutic procedures that has been developed using a curved linear-array echoendoscope. Technically, EUS-BD includes rendezvous techniques via transesophageal, transgastric, and transduodenal routes, EUS-guided choledochoduodenostomy (EUS-CDS), and EUS-guided hepaticogastrostomy (EUS-HGS). Published data have demonstrated a high success rate, albeit with a comparatively high rate of nonfatal complications for EUS-CDS and EUS-HGS, and a comparatively low success rate with a low complication rate for the rendezvous technique. At present, these procedures represent an alternative to surgery or percutaneous transhepatic biliary drainage (PTBD) for patients with obstructive jaundice when endoscopic biliary drainage (EBD) has failed. However, these procedures should be performed in centers with extensive experience in linear EUS and therapeutic biliary ERCP. Large prospective studies are needed in the near future to establish standardized EUS-BD procedures as well as to perform controlled comparative trials between EUS-BD and PTBD, between rendezvous techniques and direct-access techniques (EUS-CDS and EUS-HGS), and between EBD and EUS-BD.
Biopsy, Fine-Needle ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochostomy ; Dioxolanes ; Drainage ; Endoscopy ; Endosonography ; Fluorocarbons ; Humans ; Jaundice, Obstructive ; Transducers

  Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression.  Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing.   Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset.  Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.

Purpose: This study was performed to determine the prognostic value of lymphocyte-to-CRP ratio after curative resection for hepatocellular carcinoma. Methods: Between July 2010 and October 2021, 173 consecutive patients (144 male, 29 female) who underwent surgical resection for pathologically confirmed hepatocellular carcinoma were included in this retrospective study. Cox regression analysis was used to evaluate the relationship between clinicopathological characteristics and recurrence-free survival (RFS) and overall survival (OS). A P-value of <0.05 was considered statistically significant. Results: The patients (mean age, 71 years) were stratified into high (≥9,500, n = 108) and low (<9,500, n = 65) lymphocyteto-CRP ratio groups. The low lymphocyte-to-CRP ratio group had significantly worse RFS and OS. Low lymphocyte-toCRP ratio (hazard ratio [HR], 1.865; 95% confidence interval [CI], 1.176–2.960; P = 0.008), multiple tumors (HR, 3.333; 95% CI, 2.042–5.343; P < 0.001), and microvascular invasion (HR, 1.934; 95% CI, 1.178–3.184; P = 0.009) were independently associated with RFS, whereas low albumin-to-globulin ratio (HR, 2.270; 95% CI, 1.074–4.868; P = 0.032), α-FP of ≥25 ng/mL (HR, 2.187; 95% CI, 1.115–4.259; P = 0.023), and poor tumor differentiation (HR, 2.781; 95% CI, 1.041–6.692; P = 0.042) were independently associated with OS. Lymphocyte-to-CRP ratio had a higher area under the curve (0.635) than other inflammation-based markers (0.51–0.63). Conclusion Lymphocyte-to-CRP ratio is superior to other inflammation-based markers as a predictor of RFS in patients with surgically resected hepatocellular carcinoma.

  Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression.  Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing.   Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset.  Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.

Objective: Adverse reactions are sometimes induced by contrast media used for medical imaging and can be life-threatening. Thus, appropriate management is important for patient safety. The purpose of this study was to clarify the actual management of adverse reactions induced by contrast media in hospitals, the opportunities for intervention by hospital pharmacy departments and the attitudes of hospital pharmacists regarding the risk of adverse reactions.Methods: A self-administered questionnaire survey was conducted in the pharmacy departments of 16 hospitals (approximately 200 to 1,000 beds) located in the Tokyo metropolitan area of Japan. The survey asked about the presence or absence of internal rules or manuals regarding contrast media administration at each hospital, the management status of patients with risk factors for adverse reactions, the opportunities for interventions by pharmacists, and the opportunities for discussion regarding contrast media administration among pharmacists and other professionals.Results: Of the 16 hospitals, 10 responded to the questionnaires, and 7 of them had internal rules or manuals. These rules or manuals stipulated actions such as “do not administer contrast media” to patients with risk factor(s) for adverse reactions. For inpatients, there were opportunities for pharmacist interventions, such as drug management and guidance services and initial interviews upon hospital admission. However, for outpatients the opportunities for interventions were limited. At 5 of the 10 hospitals, pharmacists discussed contrast administration with physicians, radiologists, and other healthcare professionals.Conclusion: The present study reveal that many hospitals take great care in deciding on the administration of contrast media to patients at risk of adverse drug reactions. Our results indicate that the limited opportunities for “outpatient intervention" is an issue in the hospital pharmacy department's participation for proper use of contrast media.

Objectives: To reveal a relationship between bathing and sleep quality making for healthy aging. Materials and Methods: A population based self-administered mail survey was conducted for randomly selected or all independent people without long-term care needs aged 65 and over in 31 municipalities of Japan in 2010. This data is a part of the Japan Gerontological Evaluation Study (JAGES) project. Frequency of bathing using bathtub in summer and winter was asked. Logistic regression analyses were applied to estimate univariate and multivariate odds ratios of bad sleep quality by regular bathing (7 times or more per week for average of summer and winter) adjusting sex, age, equivalized household income, self-rated health, depression, working status, and region. Results: Response rate of the mail survey was 66.3%. The number of people who made a valid answer for bathing was 18,090. Among them, 53.0% did bathing 7 times a week, 44.6% did less than 7 times, and 2.4% did more than 7 times. Odds ratios by regular bathing were shown on the tables. Most of them indicated significantly low risk for sleeping problems. Conclusion: Regular bathing would be helpful to better sleep quality. After the survey, we are now following up the participants for incidence of long-term care needs and death.