Objective: The package inserts of over-the-counter (OTC) drugs may contain yojokun (precepts for health care) that are helpful for preventing illnesses and improving symptoms. However, it is unclear whether yojokun actually catch the attention of users and serve as a useful information resource for self-medication. With the aim of contributing to the promotion of self-medication, this study investigated the status of yojokun inclusion in package inserts and the level of awareness among users, and considered the future utilization of yojokun. Methods: The package inserts of OTC drugs listed on the website of the Pharmaceuticals and Medical Devices Agency were searched by pharmacological classification, and the inclusion of yojokun was checked. Additionally, questionnaire surveys of OTC drug purchasers, pharmacists/registered sellers, and OTC drug sales companies were conducted.Results: Of the 7,508 OTC drugs surveyed, 654 (8.7%) had yojokun listed in the package insert. The contents included a concise, bulleted list of tips for daily living to prevent symptoms from worsening and to heal quickly, with illustrations and other information. The awareness rate of yojokun was 22.0% among OTC drug purchasers and 38.8% among pharmacists/registered sellers, and 91.4% of pharmacists/registered sellers answered that yojokun are useful for self-medication. Regarding sales companies, 61.5% stated that they would like to include yojokun in package inserts, but they lacked the ability to prepare evidence-based yojokun and secure space for them in the package inserts. Conclusion: For OTC drug users, yojokun provide useful information to promote appropriate self-medication. However, the awareness of OTC drug users and pharmacists/registered sellers is low, and the information is not fully utilized. In the future, it will be necessary to further disseminate yojokun and establish a system for providing standardized yojokun.

BACKGROUND: There is little data on the association between the lower nutrition represented by serum albumin levels and related factors in a general population. The present study aimed to determine whether the albumin level positioned as some kind of biomarker with frailty measures, trace elements, and an inflammation marker. METHODS: In 2018, we performed an epidemiological survey in 1368 subjects who resided in Tanushimaru, Japan, in which we examined the blood chemistry including albumin, trace elements, hormone levels, and carotid ultrasonography. Albumin levels were categorized into 4 groups (G1 [3.2-3.9 mg/dL], G2 [4.0-4.3 mg/dL], G3 [4.4-4.6 mg/dL], and G4 [4.7-5.3 mg/dL]). The participants underwent measurements of handgrip strength and were tested by asking to walk 5 m. Their cognitive functions were evaluated by the mini-mental state examination (MMSE). RESULTS: Multiple stepwise regression analysis demonstrated that albumin levels were significantly and independently associated with age (inversely), systolic blood pressures, estimated glomerular filtration rate (eGFR), MMSE score, frailty measures (handgrip strength), an inflammation marker (high-sensitivity C-reactive protein), hormones (growth hormone (inversely) and insulin-like growth factor-1), and trace elements (calcium, magnesium, iron, and zinc), with a linear trend. CONCLUSIONS Lower albumin levels, even in the normal range, were found to be related factors of frailty measures, trace elements, and an inflammation marker in a general population.
Aged ; Albumins/metabolism* ; Biomarkers/blood* ; Cross-Sectional Studies ; Female ; Frailty/physiopathology* ; Hand Strength/physiology* ; Humans ; Inflammation/blood* ; Japan ; Male ; Trace Elements/blood*

Purpose: Naldemedine is a peripheral µ-opioid receptor antagonist, including the treatment of opioid-induced constipation (OIC) . However, diarrhea is known as its side effect. We conducted a study focusing on the administration period of opioid analgesics before the start of naldemedine to clear predictors of diarrhea due to Naldemedine. Method: All data were retrospectively collected from the electronic medical record system. We investigated patients who initially administrated naldemedine at Nagasaki University Hospital from June 1 2017 to March 31 2019. Result: One hundred thirty-two patients were subject of investigation. The incidence of diarrhea was 25.0%. The result of the multivariate analysis showed that significant predictors of diarrhea were associated with the opioid analgesics usage period longer than 7 days before naldemedine initiation (odds ratio: 3.76, 95% confidence interval: 1.53-9.20, p=0.004). Discussion: When naldemedine was used for OIC, diarrhea may be avoided by using within 7 days after opioid analgesics.

Objective: We have developed an automatic vigilance system (AVS) that automatically reports adverse drug reactions (ADR) based on laboratory finding abnormalities and symptom keywords in electronic medical records.　In this study, we aimed to evaluate the impact of detecting ADR using AVS on medical treatment.Methods: In AVS, drugs and their ADR signals, which would be detected and reported by AVS to pharmacists, were defined.　Pharmacists evaluated the severity of these signals to identify whether these signals should be discussed with the doctor, continued to be followed up, or ignored.　We investigated detection of ADR at University of Fukui Hospital between April 2016 and March 2017 along with whether prescriptions were modified because of ADR and the contribution of AVS.　Assuming that ADR had worsened without appropriate treatment, medical expenses needed for treating severe ADR were calculated.Results: In total, 325 signals were defined for 146 drugs.　There were 9,103 ADR signals confirmed by pharmacists for 8,531 subjects.　Of these, 12 and 164 signals were discussed with the doctor and continuously observed, respectively.　The pharmacist's suggestions based on AVS led to prescription modifications in 10 cases, corresponding to a reduction of 2.56 million yen in medical expenses in the event that these cases become severe.Conclusion: AVS assisted prescription revisions because of ADR and is thought to contribute to the prevention of worsening of ADR and reduction of medical expenses.

  Komono Town is a well-known spa and health resort in Mie Prefecture. Komono Town has been seeking ways to promote the activities of hot spring area and health resources in surrounding areas. As part of these efforts, Komono Town has developed town-walk programs to promote the health of local residents. In this study, focusing on effect of walking on relaxation, we compared levels of stress hormones and emotional scores obtained before and after walking.  After giving their informed consent, adult participated in two walking programs, each for a distance of approximately 7 km. Salivary cortisol levels were measured before and after intervention. In addition, the Mood Check List-Short form. 2 (MCL-S.2) and a Visual Analog Scale (VAS) were used to rate emotions before and after intervention.  In both programs, walking tended to lower levels of salivary cortisol than resting. Low levels of cortisol, an adrenocortical hormone released during a state of predominantly sympathetic nervous activity, are thought to reflect mental relaxation; our result implies that the walking program enhanced relaxation in subjects. In addition, both MCL-S.2 and VAS rating showed that the subjects tended to feel better, more relaxed and less anxious after intervention.   These findings suggest that the walking programs are beneficial human body thorough, for example, enhanced relaxation.

Since distal femoral varus osteotomy (DFO)
Asian Continental Ancestry Group ; Humans ; Japan ; Knee ; Osteoarthritis ; Osteotomy ; Tibia ; Weight-Bearing

Several prospective studies on laparoscopy-assisted distal gastrectomy for early gastric cancer have been initiated, but no prospective study evaluating laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy has been completed to date. A non-randomized confirmatory trial was commenced in April 2015 to evaluate the safety of laparoscopy-assisted total gastrectomy and laparoscopy-assisted proximal gastrectomy for clinical stage I gastric cancer. A total of 245 patients will be accrued from 42 Japanese institutions over 3 years. The primary endpoint is the proportion of patients with anastomotic leakage. The secondary endpoints are overall survival, relapse-free survival, proportion of patients with completed laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy, proportion of patients with conversion to open surgery, adverse events, and short-term clinical outcomes. The UMIN Clinical Trials Registry number is UMIN000017155.
Anastomotic Leak ; Asian Continental Ancestry Group ; Conversion to Open Surgery ; Gastrectomy* ; Humans ; Japan* ; Laparoscopy ; Medical Oncology* ; Non-Randomized Controlled Trials as Topic ; Prospective Studies ; Stomach Neoplasms*

  Komono Town is a well-known spa and health resort in Mie Prefecture. Komono Town has been seeking ways to promote the activities of hot spring area and health resources in surrounding areas. As part of these efforts, Komono Town has developed town-walk programs to promote the health of local residents. In this study, focusing on effect of walking on relaxation, we compared levels of stress hormones and emotional scores obtained before and after walking.

  After giving their informed consent, adult participated in two walking programs, each for a distance of approximately 7 km. Salivary cortisol levels were measured before and after intervention. In addition, the Mood Check List-Short form. 2 (MCL-S.2) and a Visual Analog Scale (VAS) were used to rate emotions before and after intervention.

  In both programs, walking tended to lower levels of salivary cortisol than resting. Low levels of cortisol, an adrenocortical hormone released during a state of predominantly sympathetic nervous activity, are thought to reflect mental relaxation; our result implies that the walking program enhanced relaxation in subjects. In addition, both MCL-S.2 and VAS rating showed that the subjects tended to feel better, more relaxed and less anxious after intervention.

  These findings suggest that the walking programs are beneficial human body thorough, for example, enhanced relaxation.

Objective: Several drugs can cause analytical interference in clinical laboratory tests.  To prevent errors in clinical judgment as a result of false data, we investigated the information available on the interference of ethical drugs in these tests.
Methods: We examined the information available by collecting and evaluating information in package insert leaflets, collecting and evaluating clinical data on three drugs (bucillamin, captopril, and epalrestat) which affect clinical laboratory test results, and conducting a questionnaire survey of healthcare workers.
Results: From the information available on package inserts, 227 drugs were identified as having the potential to interfere with the chemical reactions used in clinical laboratory tests.  However, the insert information is not sufficient for use in clinical settings because the frequency rate and causative factors of interference are not stated clearly.  The clinical survey results reveal that 40% of patients taking bucillamine and 20% of patients taking epalrestat tested false-positive for urinary ketones.  According to the questionnaire results, medical technologists were more interested than pharmacists and physicians in how drugs affect clinical laboratory tests.
Conclusion: The information currently available on the interference of drugs in clinical laboratory tests is problematical, and it is therefore necessary to collect more clinical data for the proper interpretation and evaluation of abnormal laboratory values.