1.Advance Care Planning by Rehabilitation Professionals: an Experience with a Patient with Nonmalignant Respiratory Disease
Takeshi KAKUTA ; Yuki OYAMA ; Yoshiko FUKUMURA ; Mizuki SUGIURA
Palliative Care Research 2023;18(3):201-205
We herein report a case of a 76-year-old male patient with chronic obstructive pulmonary disease whose advance care planning (ACP) was facilited by rehabilitation staff by utilizing dialogue in rehabilitation settings, mainly in the context of conditioning and self-management during pulmonary rehabilitation. When a rehabilitation professional is involved in ACP, it is easy to be involved in the so-called ACP in the broad sense. Compared to other professions, rehabilitation professionals have more time being with a patient for dialogue and can discuss the patient's values and future concerns from a life-centered perspective. To promote ACP in the practical settings, rehabilitation professionals, who have the advantage of having more time for dialogue than other professions, need to be involved in ACP by taking advantage of repeated opportunities for dialogue.
2.Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry
Katsuhiro ARAI ; Reiko KUNISAKI ; Fumihiko KAKUTA ; Shin-ichiro HAGIWARA ; Takatsugu MURAKOSHI ; Tadahiro YANAGI ; Toshiaki SHIMIZU ; Sawako KATO ; Takashi ISHIGE ; Tomoki AOMATSU ; Mikihiro INOUE ; Takeshi SAITO ; Itaru IWAMA ; Hisashi KAWASHIMA ; Hideki KUMAGAI ; Hitoshi TAJIRI ; Naomi IWATA ; Takahiro MOCHIZUKI ; Atsuko NOGUCHI ; Toshihiko KASHIWABARA ; Hirotaka SHIMIZU ; Yasuo SUZUKI ; Yuri HIRANO ; Takeo FUJIWARA
Intestinal Research 2020;18(4):412-420
Background/Aims:
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods:
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results:
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturingon-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.