1.Preferences and use of Japanese or Brazilian medicines by Japanese Brazilian immigrants in Japan
Yuki Nakagawa ; Leo Kawaguchi ; Michiyo Higuchi ; Nobuo Kawazoe ; Chifa Chiang ; Hiroshi Yatsuya ; Atsuko Aoyama
Journal of International Health 2012;27(3):213-223
Introduction
The use of medicines among Brazilian workers in Japan has not been documented. This study examines the preferences and use of medicines among Brazilian workers of Japanese origin in Japan.
Methods
A cross-sectional survey was conducted in 2011 in a community in Nagoya, where many Brazilian workers lived. Questionnaires were distributed to 206 Brazilian households, and asked about preferences and use of Japanese or Brazilian medicines. Associations with socioeconomic factors were analyzed using Fisher's exact test.
Results
The response rate was 36% (74 households). Of these, 66% had lived in Japan for over 10 years, and 88% held health insurance. Over 80% reported a preference for Japanese medicines. However, Brazilian medicines were used in more than 40% of the households. Employed Brazilians tend to use Brazilian medicines compared to the unemployed. Most respondents answered that Brazilian medicines were more effective, but were more expensive and produced worse side effect than Japanese medicines.
Households with children showed a preference for Japanese medicines for children's illnesses. However, more Brazilian medicines were used when the length of household's stay in Japan was less than 10 years, and when the respondent's perceived listening ability of Japanese language was poor.
Conclusion
Almost all respondents were using the medicines they preferred, suggesting that access to medicine was generally good in the community. However, 40% of respondents used Brazilian medicines, despite their long stay in Japan, their health insurance status, and their recognition of Japanese medicines as inexpensive and safe. This might be explained by familiarity with Brazilian medicines, or perception of their effectiveness.
Continuous self-administration of medicines without consultation has potential harm to the health. This study also suggests the importance of arranging social environments such as facilitating the taking of sick leaves, so that immigrant workers can secure their access to health services.
2.Analgesic effects and distribution of cutaneous sensory blockade of quadratus lumborum block type 2 and posterior transversus abdominis plane block: an observational comparative study
Yuki AOYAMA ; Shinichi SAKURA ; Shoko ABE ; Minori WADA ; Yoji SAITO
Korean Journal of Anesthesiology 2020;73(4):326-333
Background:
The posterior transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) were developed for postoperative pain control after lower abdominal surgery. However, there is little data regarding their effects. Their analgesic effects and the distribution of the cutaneous sensory blockade were observed in patients undergoing laparoscopic gynecologic surgery.
Methods:
After an induction of general anesthesia, patients alternately received bilateral ultrasound-guided QLB type 2 (QLB2) or posterior TAPB using 20 ml of 0.375% levobupivacaine on each side. The measurements included visual analogue pain scores (VAS), cutaneous sensory blockade in each dermatome, demands for postoperative analgesics, and complications for up to 48 h after the block. Our primary endpoint was VAS at 24 h after the block.
Results:
Forty patients completed the study. The VAS at rest was significantly lower after QLB2 than that after TAPB at 48 h, but not at 24 h. Neither group differed in VAS when coughing at any point in time. Postoperative demands for fentanyl and other analgesics also did not differ for either block. The majority of injections produced a cutaneous sensory blockade in the T11 and T12 dermatomes in both groups. The median number of dermatomes blocked was limited to three dermatomes after either block. No severe complication related to either block was observed.
Conclusions
The analgesic effects of QLB2 and posterior TAPB did not differ in patients undergoing laparoscopic gynecologic surgery. The cutaneous sensory blockade produced was limited to three dermatomal levels in the majority of patients. However, these findings need to be confirmed through a larger comparative study.