1.An Investigation of the Oral Intake Recovery Rate as Defined by the 2014 Medical Treatment Reward Revision in Japan
Tomoyuki NAKAMURA ; Mikoto BABA
The Japanese Journal of Rehabilitation Medicine 2015;52(11):713-719
Objective : The 2014 Medical Treatment Reward Revision in Japan newly defines the oral intake recovery rate and requires a change of more than 35% to calculate various additions and subtractions. We calculated the recovery rate in various diseases and clarified some inherent problems. Methods : From April 2012 to March 2014, we retrospectively investigated the age, sex, removal rate from nasal nutrition or gastric fistula, oral intake recovery rate and days until removal of 286 inpatients with nasal nutrition or gastric fistula for dysphagia. Results : The removal rates for stroke, brain injury, oral and laryngopharyngeal cancer and other diseases were nearly always more than 50% because the disease did not cause dysphagia directly or the rehabilitation was effective for treating the remaining dysphagia. But the removal rates for neurodegenerative disease, complications due to stroke and brain injury in the chronic phase and respiratory disease did not reach 35% because the previous dysphagia progressed or actualized. Almost all oral intake recovery rates did not extend to 35% for exclusion of oral intake recovery within one month. Conclusion : The criteria of oral intake recovery rate needs to be reviewed in respect to setting goals to match the patient's underlying disease and to evaluate the possibility for early rehabilitation.
2.The Relation between the Number, Kind and Total Amount of Psychoactive Drugs Used and the Outcome of Dysphagia in Patients with Psychiatric Disorders
Tomoyuki NAKAMURA ; Ichiro FUJISHIMA ; Norimasa KATAGIRI ; Ritsu NISHIMURA ; Naoki KATAYAMA ; Koji WATANABE
The Japanese Journal of Rehabilitation Medicine 2013;50(9):743-750
Objective : To examine the relation between psychoactive drugs and the outcome of dysphagia in patients with psychiatric disorders. Methods : We examined 53 inpatients who were prescribed speech therapy in the psychiatry ward of our hospital from January 2011 to April 2012. We categorized the patients into a poor outcome group and a good outcome group by the necessity for alternative nutrition at discharge and analyzed the number and kind of typical antipsychotic, atypical antipsychotic, hypnotic, antidepressant and mood stabilizer, total amount of typical antipsychotic, atypical antipsychotic used at admission and at discharge, sex, psychiatric disorder, central nervous system disease, aspiration pneumonia, duration of hospitalization, psychiatric disorder disease period, speech therapy intervention period and GAF scale at admission. Results : The outcome of dysphagia had a significant relation with the number and kind of antipsychotic used, especially typical antipsychotic used at admission. The good outcome group had a higher total amount of antipsychotic use, especially atypical antipsychotics. Conclusion : Long-term practical oral intake should not comprise antipsychotic polypharmacy, especially typical antipsychotics before onset of dysphagia, but should instead consist of a monopharmacy approach with atypical antipsychotics.
3.Gastrointestinal Complications and Intestinal Stasis after Videofluoroscopic Examination of Swallowing
Yosuke WADA ; Norimasa KATAGIRI ; Yuri SATO ; Ikuko HASHIMOTO ; Tomoyuki NAKAMURA ; Ichiro FUJISHIMA
The Japanese Journal of Rehabilitation Medicine 2010;47(11):801-805
The purpose of this study was to investigate the occurrence of gastrointestinal complications and intestinal stasis after a videofluoroscopic examination of swallowing. Of 121 inpatients who underwent videofluoroscopic examinations from October 2008 to March 2009 and September to October 2009, we analyzed 33 patients who underwent abdominal X-ray four days after their videofluoroscopic examination. Six of 33 patients (18.2%) suffered gastrointestinal symptoms. Three patients had diarrhea, two had vomiting, and one had abdominal distention. The incidence of gastrointestinal complications after videofluoroscopic examination was estimated to be two of 33 patients (6.1%) because we assumed that two of the six patients' condition was related to their videofluoroscopic examination and that the other four were related to other factors. One of two patients with a poor general condition developed pneumonia after vomiting. There was no relationship between the incidence of gastrointestinal complications and the patient's background. Intestinal stasis as detected by X-ray was identified in 25 of 33 patients (75.8%). There was more barium sulfate intake in the patients who had intestinal stasis than the patients who had no intestinal stasis. There was no relationship between intestinal stasis and the incidence of gastrointestinal complications. Our findings suggest that the risk of gastrointestinal complications after videofluoroscopic examination is low except in patients with a poor general condition.
4.Controlled Clinical Trials Using the Envelope Method for Urinary Dysfunction. The Effectiveness of the zhongji (cv-3).
Munenori MINAGAWA ; Tatsuyo ISHIGAMI ; Shigeru HORI ; Norikazu TANAKA ; Hironori NAKAMURA ; Yoshiyuki KAWASE ; Teruo HATTORI ; Akira KINUTA ; Hidetaka HIRAMATU ; Hisashi KOUDA ; Yoshikazu TANAKA ; Hiroyasu FUKUDA ; Ako NAKAMURA ; Tomoyuki IZAWA ; Haruhiko IJIMA ; Takayuki NAKAMURA ; Yasuzo KURONO
Journal of the Japan Society of Acupuncture and Moxibustion 1999;49(3):383-391
At the 45th Japanese National Acupuncture and Moxibustion Conference, Kitakoji et al. of the Research Committee's Urology Group reported the results of controlled clinical trials, using the envelope method, on the effectiveness of acupuncture for urinary dysfunction. This was presented as a case in which the “Guidelines and Recommendations for clinical Trials in Acupuncture” were applied in actual clinical research. A controlled investigation was carried out by the Information and Evaluation Group, Research Section, Aichi Regional Association, at multiple institutions (9 hospitals and clinics) on the effectiveness of the zhongji (cv-3) point for urinary dysfunction, using the envelope method of Kitakoji et al. Although the zhongji (cv-3) point was not found to be effective against urinary dysfunction, we were able to demonstrate that it is possible to conduct controlled clinical trials at multiple institutions based on soft data.
5.Bronchial Schwannoma Masquerading as Cause of Hemoptysis in a Patient with Pulmonary Embolism
Tomoko Nagatomo ; Takeshi Saraya ; Masuo Nakamura ; Yasutaka Tanaka ; Akira Nakajima ; Atsuko Yamada ; Yukari Ogawa ; Naoki Tsujimoto ; Erei Sohara ; Toshiya Inui ; Mitsuru Sada ; Manabu Ishida ; Miku Oda ; Ichiro Hirukawa ; Masachika Fujiwara ; Teruaki Oka ; Hidefumi Takei ; Tomoyuki Goya ; Hajime Takizawa ; Hajime Goto
General Medicine 2013;14(1):67-71
A 78-year-old woman who had a history of left deep venous thrombosis was referred to our hospital with a sudden hemoptysis. Thoracic computed tomography showed a solitary pulmonary nodule in the right lower lobe. Based on her medical history of deep venous thrombosis, she was tentatively diagnosed as having pulmonary embolism and successfully treated by inserting an inferior vena cava filter and anticoagulant therapy with warfarin [Please confirm whether previous sentence is correct]. However, the lung nodule on thoracic computed tomography was still depicted four months later. With suspicion of a malignant tumor, including possible lung cancer, a right segmentectomy was performed. Pathological assessment of the resected specimen showed the tumor was derived from the right bronchial wall, but was not ruptured into the intratracheal lumen, as well as coexistence with intraalveolar hemorrhage near the tumor. The lung nodule was diagnosed as bronchial schwannoma. Thus, the origin of the hemoptysis was found to be pulmonary embolism due to deep vein thrombosis, and not by bronchial schwannoma, which was also present in the lung.
6.An Update of Sports Medicine in Persons with Disabilities—Surviving Skeleton Muscles are Endocrine Organs—
Fumihiro TAJIMA ; Kazunari FURUSAWA ; Taro NAKAMURA ; Hidenobu OKUMA ; Yuichi UMEZU ; Makoto IDE ; Takashi MIZUSHIMA ; Mari UETA ; Takeshi NAKAMURA ; Takamitsu KAWAZU ; Hideki ARAKAWA ; Tomoyuki ITO ; Midori YAMANAKA ; Ken KOUDA ; Masaki GOTO ; Yusuke SASAKI ; Nami KANNO ; Takashi KAWASAKI ; Yasunori UMEMOTO ; Tomoya SHIMOMATSU ; Motohiko BANNO ; Hiroyasu UENISHI ; Hiroyuki OKAWA ; Ko ASAYAMA
The Japanese Journal of Rehabilitation Medicine 2010;47(5):304-309
7.Predicting outcomes to optimize disease management in inflammatory bowel disease in Japan: their differences and similarities to Western countries.
Taku KOBAYASHI ; Tadakazu HISAMATSU ; Yasuo SUZUKI ; Haruhiko OGATA ; Akira ANDOH ; Toshimitsu ARAKI ; Ryota HOKARI ; Hideki IIJIMA ; Hiroki IKEUCHI ; Yoh ISHIGURO ; Shingo KATO ; Reiko KUNISAKI ; Takayuki MATSUMOTO ; Satoshi MOTOYA ; Masakazu NAGAHORI ; Shiro NAKAMURA ; Hiroshi NAKASE ; Tomoyuki TSUJIKAWA ; Makoto SASAKI ; Kaoru YOKOYAMA ; Naoki YOSHIMURA ; Kenji WATANABE ; Miiko KATAFUCHI ; Mamoru WATANABE ; Toshifumi HIBI
Intestinal Research 2018;16(2):168-177
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract, with increasing prevalence worldwide. IBD Ahead is an international educational program that aims to explore questions commonly raised by clinicians about various areas of IBD care and to consolidate available published evidence and expert opinion into a consensus for the optimization of IBD management. Given differences in the epidemiology, clinical and genetic characteristics, management, and prognosis of IBD between patients in Japan and the rest of the world, this statement was formulated as the result of literature reviews and discussions among Japanese experts as part of the IBD Ahead program to consolidate statements of factors for disease prognosis in IBD. Evidence levels were assigned to summary statements in the following categories: disease progression in CD and UC; surgery, hospitalization, intestinal failure, and permanent stoma in CD; acute severe UC; colectomy in UC; and colorectal carcinoma and dysplasia in IBD. The goal is that this statement can aid in the optimization of the treatment strategy for Japanese patients with IBD and help identify high-risk patients that require early intervention, to provide a better long-term prognosis in these patients.
Asian Continental Ancestry Group
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Colectomy
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Colitis, Ulcerative
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Colorectal Neoplasms
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Consensus
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Crohn Disease
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Disease Management*
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Disease Progression
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Early Intervention (Education)
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Epidemiology
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Expert Testimony
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Gastrointestinal Tract
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Hospitalization
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Humans
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Inflammatory Bowel Diseases*
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Japan*
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Prevalence
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Prognosis
8.Effect of elemental diet combined with infliximab dose escalation in patients with Crohn's disease with loss of response to infliximab: CERISIER trial.
Tadakazu HISAMATSU ; Reiko KUNISAKI ; Shiro NAKAMURA ; Tomoyuki TSUJIKAWA ; Fumihito HIRAI ; Hiroshi NAKASE ; Kenji WATANABE ; Kaoru YOKOYAMA ; Masakazu NAGAHORI ; Takanori KANAI ; Makoto NAGANUMA ; Hirofumi MICHIMAE ; Akira ANDOH ; Akihiro YAMADA ; Tadashi YOKOYAMA ; Noriko KAMATA ; Shinji TANAKA ; Yasuo SUZUKI ; Toshifumi HIBI ; Mamoru WATANABE
Intestinal Research 2018;16(3):494-498
No abstract available.
Crohn Disease*
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Food, Formulated*
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Humans
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Infliximab*
9.Survey of teachers at the acupuncture and moxibustion college teachers regarding video teaching materials linking acupuncture and subcutaneous tissue
Masako NAKAMURA ; Hideaki MATSUKUMA ; Ryota TSUJI ; Nao HORIKAWA ; Tomoyuki NABETA
Journal of the Japan Society of Acupuncture and Moxibustion 2023;73(2):131-135
[Objective] Instructional videos on five of the 17 acupuncture techniques (hereinafter referred to as "techniques") were created, and a questionnaire was distributed among acupuncture and moxibustion college teachers to evaluate the utility of the educational materials.[Methods] The sparrow pecking technique (straight and oblique stabbing), gyration, rotation and twisting techniques, as well as vibration stimulation, were performed and the hand was simultaneously imaged with a diagnostic ultrasound device and filmed with a video camera. The questionnaire and a QR code for viewing the videos were sent to training schools by mail. The questionnaire included open-ended and multiple-choice questions regarding the teaching status of the techniques, changes in perception of the techniques after viewing the video, and the value of using the video as a teaching tool.[Results] Responses were received from nine schools (14 teachers). Each technique was taught only once at five of the schools. For all the techniques featured in the videos, not all the respondents answered that the subcutaneous and muscular tissue movements were consistent with their perceptions. Meanwhile, only 35.7% of the respondents had perceptions that were congruent with the video on vibratory stimulation. According to 78.6% of the respondents, instructional videos on these techniques were deemed to be necessary.[Discussion and Conclusion] The minimal repetition on the education of acupuncture and moxibustion techniques implies a lack of emphasis regarding these skills. The dissonance between the subcutaneous and muscular tissue movements that were familiar to the instructors and those discussed in the video highlighted the significant differences in skills training among the various training institutions. Based on this feedback, instructional videos can be considered essential in accurately teaching acupuncture and moxibustion techniques by providing visual aids.
10.Early Physical Therapy Intervention for Frail Patients Isolated with COVID-19
Keisuke INOUE ; Yuma NAKAMURA ; Masaki HAKOMORI ; Kazunori TOYODA ; Tomoyuki OGATA ; Shouichirou ISHIHARA ; Shinichi OGAWA ; Ayako KOUZU ; Masashi TAKAHASHI
Journal of the Japanese Association of Rural Medicine 2021;70(1):53-61
Few reports have described assessment methods or exercise interventions in detail for patients isolated with COVID-19. Here, we report our experience of providing physical therapy to these patients based on motor assessment with consideration of infection control. This study involved 4 patients with COVID-19 who needed physical therapy due to a fall or frailty during isolation. The assessment method used was intended to minimize physical contact, to be easily performed, and to reflect muscle strength and balance. Based on the assessment, we created exercise programs and provided exercise intervention to the patients in cooperation with nurses. One patient was discharged early; the other 3 patients showed improved motor function and activities of daily living as a result of the intervention in the acute ward. However, they needed ongoing rehabilitation in the rehabilitation ward. No physical therapists showed signs of COVID-19 infection. Performing motor assessments and providing exercise intervention to these patients isolated with COVID-19 contributed to motor improvement and enabled us to promptly determine whether they needed ongoing rehabilitation.