Patients with heart failure often have difficulty in stopping cardiotonic drugs as the disease stage progresses, and long-term hospitalization is a factor that significantly reduces quality of life. To solve this problem, in September 2017, our hospital started an initiative to support overnight stays at home by using a portable precision infusion pump and continuously injecting cardiotonic drugs with the approval of the hospital’s medical ethics committee. Since there are few case reports of similar efforts in Japan, here we describe the use of drugs and the content of the intervention by pharmacists. The drug is administered via a peripherally inserted central venous catheter using an ambulatory precision infusion pump. The pharmacist calculates the drug dose and flow rate required during the at-home period using spreadsheet software, and proposes a prescription to the doctor. In addition, if multiple cardiotonics and diuretics are administered, the presence or absence of compounding changes is confirmed, and the feasibility of mixing should be examined, and then prepared aseptically on a clean bench on the day of administration. We started to administer catecholamine while in the hospital on the day before the stay at home. Then we prepared the catecholamine in a portable precision infusion pump and administered it during stay at home. To date, we have supported 8 cases in stays at home without emergency hospitalization or sudden death due to exacerbation of heart failure.

Background: The lack of clarity regarding the significance of engaging in research activities during a clinical career has been identified as a contributing factor to the trend of decreasing research involvement among young physicians.　Methods: A mixed-methods study was conducted within a clinical department of a private university to investigate physicians' perceptions of the correlation between research experience and clinical competency.　Results: Quantitative analysis of survey data indicated that physicians acknowledge the contribution of research activities to their clinical competency. Qualitative data revealed subjective perceptions among participants regarding these contributions.　Conclusions: This study highlights that physicians recognize research activities as an opportunity to enhance their clinical competency. Clarifying the relationship between research activity and clinical competency is expected to support the development of more effective research programs aiming at improving physicians' clinical competency.

Introduction: To elucidate the issues surrounding adolescents' Internet use in social minority groups, this study investigated the current situation of Internet addiction among Brazilian students who live in A city in Japan.Methods: The participants were 342 local Brazilian students attending international schools. A cross-sectional study using a self-administered questionnaire in Brazilian-Portuguese was conducted. As a primary outcome, we used Young's Internet Addiction Test (IAT) to evaluate the level of self-reported Internet addiction. Social demographics (i.e. age, sex, etc. ), lifestyle (i.e. the time for Internet use, sleeping hours, etc. ), and depressive tendency (Patient Health Questionnaire 2, PHQ2) were also assessed. The χ-square test and logistic regression analysis were used for analysis.Results: The response rate was 65% (222; 111 males and 111 females). Factors related to an IAT score of 50 or higher were sleeping hours (<7.5 hours) (OR: 0.38, 95%CI: 0.21-0.68), the time for Internet use (≥4 hours) (2.6, 1.4-4.8), and PHQ2 score (≥3) (6.2, 3.3-11.5). On logistic regression analysis, an IAT score ≥50 was positively associated with the time for Internet use and PHQ2 score ≥3.Conclusion: The self-report of high Internet addiction among Brazilian students in A city in Japan was significantly related to the time for Internet use and depressive tendency.

Although the recent revision of the ministerial ordinance on Good Post-marketing Study Practice (GPSP) included the utilization of medical information databases for post-marketing surveillance, there has been limited research on the validity of diagnosis codes and other outcome definitions in Japanese databases such as administrative claims (“receipt”) database. This task force proposed how to conduct good validations studies, based on the narrative review on around 100 published papers around the world. The established check list consists of ： (ⅰ) understanding the type of the database (e.g. administrative claims data, electronic health records, disease registry) ； (ii) understanding the setting of the validation study (e.g. “population-based” or not) ； (iii) defining the study outcome ； (iv) determining the way of linkage between databases ； (v) defining the gold standard ； (vi) selecting the sampling method (e.g. using the information of all patients in the database or a hospital, random sampling from all patients, random sampling from patients satisfying the outcome definition, random sampling from patients satisfying and not satisfying the outcome definition, “all possible cases” method) and sample size ； (vii) calculating the measures of validity (e.g. sensitivity, specificity, positive predictive value, negative predictive value) ； and (viii) discussing how to use the result for future studies. In current Japan, where the linkage between databases is logistically and legally difficult, most validation studies would to be conducted on a hospital basis. In such a situation, detailed description of hospital and patient characteristics is important to discuss the generalizability of the validation study result to the entire database. This report is expected to encourage and help to conduct appropriate validation studies.

The aim of this study is to investigate the characteristics of pre-existing physical factors associated with the onset of Osgood-Schlatter disease (OSD) in junior soccer players. Fifty-nine junior soccer players of the elementary school were included in this study. The boys who had been diagnosed as OSD were excluded. At the time of the first investigation, the subjects were examined through physical evaluation and an ultrasonography. The subjects were followed up one and a half years, and the tibial tuberosity was classified according to the growth stages using the ultrasonography. After the end of follow-up period, the subjects were divided into two groups, those with signs and symptoms of OSD that appeared during the follow up period and those without that. The Mann-Whitney U test was used for the comparison between OSD group’s and control group’s initial assessments. The players who were followed up for one and half years were 38 people. 5 knees of the 4 players were clinically diagnosed as OSD (OSD group), and the remaining 34 players with no symptoms of the OSD constituted the control group. The range of the bilateral hip external rotation, straight leg raise of the non-dominant side, and knee flexion in the OSD group were significantly lower than those in the control group (p < 0.05). We concluded that a decrease in specific joint flexibility might be related with the onset of OSD.