A questionnaire-based survey was conducted to clarify how community pharmacists recognize the legal validity of acts that involve touching their patients and to determine if the pharmacists had personal feelings of resistance toward particular acts. The questionnaire was sent to 400 community pharmacies that practiced home care and 147 valid responses were analyzed. The survey suggested that there were many pharmacists who had no objection toward measuring vital signs, such as temperature and blood pressure. Additionally, they recognized that it was necessary for doctors, other professionals, and patients to recognize their ability to measure vital signs. The survey also suggested that there were strong feelings of resistance toward invasive acts, such as insertion of an enema tube or a suppository. It was considered that these feelings were due to insufficient knowledge and experience, as well as uneasiness with hygiene issues. The necessity to participate in a practical study session was emphasized. When pharmacists recognized a problem with the legality of an act, their feelings of resistance, particularly toward examining bedsores and applying ointment on them, tended to become strong. Therefore, it was suggested that pharmacists may be able to perform the acts without feelings of resistance if the legality of the acts was clarified. Based on these findings, it is necessary to find a suitable rationale for performing each act, so that pharmacists will be able to perform the acts that involve touching their patients without feelings of resistance.

A questionnaire-based survey was administered to determine how community pharmacists recognize the necessity for and frequency of touching their patients during care giving. The questionnaire was sent to 400 community pharmacies that practiced home care, and 147 valid responses were analyzed. The survey suggested that acts recognized by pharmacists to require touching were measuring vital signs and helping patients take oral medications. It was thought that pharmacists needed to help patients in taking oral medications and also needed to determine issues related to oral intake. The survey also indicated that the frequencies of measuring vital signs and applying plasters to patients were high. Measuring vital signs was considered routine work, and applying plasters to patients was considered occasional work. Many respondents stated the need for practical study sessions on measuring vital signs. The frequency of measuring vital signs has increased because pharmacists have increasingly recognized this need. Additionally, females tended to touch their patients more frequently than males. However, there was no relationship between the frequency of examining bedsores and applying ointments on them and gender because it was thought that knowledge and experience were more important. The recognition of necessity for touching their patients was high but the frequency was comparatively low, and there was a discrepancy between the recognition of necessity and frequency. It was suggested that practical study sessions on when patients should be touched should be a high priority.

The purpose of the present study was to evaluate the prokinetic effects of mosapride with non-invasive assessment of myoelectrical activity in the small intestine and caecum of healthy horses after jejunocaecostomy. Six horses underwent celiotomy and jejunocaecostomy, and were treated with mosapride (treated group) at 1.5 mg/kg per osos once daily for 5 days after surgery. The other six horses did not receive treatment and were used as controls (non-treated group). The electrointestinography (EIG) maximum amplitude was used to measure intestinal motility. Motility significantly decreased following surgery. In the treated group, the EIG maximum amplitude of the small intestine was significantly higher than in the controls from day 6~31 after treatment. These findings clearly indicate that mosapride could overcome the decline of intestinal motility after jejunocaecostomy in normal horses.
Anastomosis, Surgical/veterinary ; Animals ; Benzamides/*pharmacology ; Cecum/*drug effects/physiology ; Electrophysiology ; Female ; Gastrointestinal Agents/*pharmacology ; Gastrointestinal Motility/*drug effects ; Horses/*physiology/surgery ; Intestine, Small/*drug effects/physiology/surgery ; Jejunostomy/veterinary ; Male ; Morpholines/*pharmacology

STUDY DESIGN: Observational cohort study. PURPOSE: To assess the surgical outcomes of posterior decompression and fusion for cervical myelopathy in patients with athetoid cerebral palsy. OVERVIEW OF LITERATURE: Patients with athetoid cerebral palsy demonstrate involuntary movements and develop severe cervical spondylosis with kyphosis. In these patients, surgery is often performed at an early age because of myelopathy. A few studies have reported about the long-term outcomes of surgical treatment; however, they contain insufficient information. METHODS: From 2003 to 2008, 13 patients with cervical myelopathy due to athetoid cerebral palsy underwent posterior fusion surgery and were included in this study. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), C2–7 angle on radiography, and need for additional surgical treatment were examined at 1 and 5 years postoperatively. RESULTS: The mean C2–7 angle was −10.5°±21.1° preoperatively and was corrected to −2.9°±13.5° immediately postoperatively. This improvement was maintained for 5 years. The JOA score was 9.5±2.5 preoperatively and 12.2±1.7 at the 5-year follow-up. NDI was 17±6.9 preoperatively and 16±7.5 at the 5-year follow-up. Patient satisfaction with surgery on a 100-point scale was 62.2±22.5 at the 5-year follow-up. Three patients needed additional surgery for loosening of screws. These results demonstrate good surgical outcomes for posterior fusion at 5 years. CONCLUSIONS: Posterior decompression and fusion should be considered a viable option for cervical myelopathy in patients with athetoid cerebral palsy.
Asian Continental Ancestry Group ; Cerebral Palsy* ; Cohort Studies ; Decompression ; Dyskinesias ; Follow-Up Studies* ; Humans ; Kyphosis ; Neck ; Patient Satisfaction ; Radiography ; Spinal Cord Diseases* ; Spine ; Spondylosis

Purpose: To describe a patient receiving maintenance hemodialysis complicated with calcific uremic arteriolopathy (calciphylaxis) in whom ulcer pain control was successfully achieved by buprenorphine. Case: A 75-year-old man was admitted due to intractable, extreme pain, which was accompanied by skin ulcers of the lower extremities. By a series of examinations including skin biopsy, the lesion was diagnosed to be calcific uremic arteriolopathy. The pain was not controllable with non-steroidal anti-inflammatory drugs and even by the nerve block. Buprenorphine, a partial agonist for the opioid receptor, markedly alleviated the mixed pain which was attenuated from Numerical Rating Scale (NRS) 10/10 to 0-2/10. Conclusion: Buprenorphine was very effective for the refractory pain control in a patient with skin ulcer due to calcific uremic arteriolopathy.