A 20-year-old woman had a tendency of belching from a young age. She began to realize that she might have excessive belching compared to other people for the past two years. She was prescribed some medicines to improve gastrointestinal function by some physicians, but her symptoms did not resolve. Aerophagia was suspected as forceful belching tends to occur soon after eating or drinking. Incidentally, ihon is a condition in which one vomits food half a day after the ingestion due to the malfunction of the digestive system. I considered her symptoms as ihon and prescribed bukuryotakushato, and her symptoms improved. This case report indicated that ihon could be defined as a symptom of forceful regurgitation of food or air, regardless of the timing after meals.

Green tea catechins are well known to be one of polyphenols, and its regular ingestion induces body fat reduction in obese individuals. Cocoa polyphenols of high-cocoa chocolate can also improve arterial stiffness. However, it is unclear whether green tea catechins improve body fat and arterial stiffness even in healthy young adults. Therefore, this study aimed to examine the effects of regular green tea intake on body fat and arterial stiffness in young adults. This randomized, controlled, parallel-group intervention study included 53 Japanese college students (mean age, 21.1 ± 0.1; men, n = 40; women, n = 13). They were randomly divided into three groups: control group (n = 14), intervention I group (n = 19), and intervention II group (n = 20). The participants ingested 500 ml/day of commercially available natural water (0 mg of catechin/day) or green tea (intervention I group, 200 mg of catechin/day; intervention II group, 400 mg of catechin/day) for 4 weeks. After 4 weeks of intervention period, no significant changes in body weight, body mass index, pulse wave velocity, and cardio-ankle vascular index were observed in all groups. However, body fat and carbon dioxide output significantly reduced only in the intervention II group. With the level of catechin concentrations increasing, significant decreasing trends were found in body fat changes and respiratory exchange ratio changes. Therefore, these findings suggest that four weeks of regular green tea intake would reduce body fat, but not arterial stiffness, in young adults.

The purpose of this study was to explore issues arising from the promotion of collaboration between general practitioners (GPs) and community pharmacists in the management of leftover medicine. The 2016 Revision of Medical Fee newly added the check boxes in the prescription form in which a physician requests the correspondence of a pharmacy when confirming leftover medicine. In this study, we conducted a questionnaire survey among GPs in three wards of Tokyo in the month of November 2016. Of the 1,256 clinics queried, 283 responded to the survey. Among those GPs responding, 86.6% were concerned about leftover medicine of their patients, while 29.3% used the check boxes. GPs who received an explanation about the change of the prescription form demonstrated a significant increase in the use of the check boxes, compared to GPs who did not (p<0.01). Of the GPs surveyed, 71.0% thought that the check boxes were an advantage in recognizing medicines that the patients did not take. An overall 67.5% of the GPs who used the check boxes revised prescriptions based on the information from pharmacists. The study suggests that by increasing collaboration between GPs and pharmacists, the information from pharmacists could be utilized to revise prescriptions and lead optimization of drug treatment.

BACKGROUND/AIMS: The influences of Helicobacter pylori eradication therapy on the disease course of inflammatory bowel disease (IBD) are still unclear. We therefore conducted a multicenter, retrospective cohort study to evaluate the safety of H. pylori eradication therapy for IBD patients. METHODS: IBD patients with H. pylori eradication from 2005 to 2015 (eradication group) and control patients (non-eradication group; 2 paired IBD patients without H. pylori eradication matched with each eradicated patient) were included. IBD exacerbation (increased/additional IBD drug or IBD-associated hospitalization/surgery) and disease improvement based on the physicians’ global assessment were investigated at baseline, and at 2 and 6 months after eradication or observation. RESULTS: A total of 429 IBD (378 ulcerative colitis, 51 Crohn’s disease) patients, comprising 144 patients in the eradication group and 285 patients in the non-eradication group, were enrolled at 25 institutions. IBD exacerbation was comparable between groups (eradication group: 8.3% at 2 months [odds ratio, 1.76; 95% confidence interval, 0.78–3.92; P=0.170], 11.8% at 6 months [odds ratio, 1.60; 95% confidence interval, 0.81–3.11; P=0.172]). Based on the physicians’ global assessment at 2 months, none of the patients in the eradication group improved, whereas 3.2% of the patients in the non-eradication group improved (P=0.019). Multivariate analysis revealed that active disease at baseline, but not H. pylori eradication, was an independent factor for IBD exacerbation during 2 months’ observation period. The overall eradication rate was 84.0%–comparable to previous reports in non-IBD patients. CONCLUSIONS: H. pylori eradication therapy does not alter the short-term disease activity of IBD.
Clarithromycin ; Cohort Studies ; Colitis, Ulcerative ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammatory Bowel Diseases* ; Metronidazole ; Multivariate Analysis ; Retrospective Studies

In junior high school, educators with many different types of specialty jobs are involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education”. Examples of these different jobs are physical education teachers, school nurses, school pharmacists. The aim of this study was to elucidate novel ideas and new directions in the future of medicine instructional education by clarifying the aims and thoughts of educators with different jobs on the education of pharmaceutical medicines and drug use. Based on the technique of Personal Attitude Construct (PAC) analysis, junior high school staff members involved in “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” were interviewed regarding their aims and thoughts. Their responses were analyzed qualitatively. Five school pharmacists, five school nurses, and four physical education teachers were interviewed. The responses revealed that school pharmacists engaged in student education from the specialized perspective of pharmacology, school nurses engaged in student education from the perspective of imminent situations, and physical education teachers engaged in student education more from the perspective of student environment. This study suggested that “education on the proper use of pharmaceutical products” and “drug-abuse resistance education” should be a collaborative effort, so there were the different perspectives and aims of educators with different specialty jobs in the instruction of junior high school students on these subjects.

Approximately 14.1 million patients have dyslipidemia in Japan. Promotion of self-medication for the prevention of dyslipidemia is needed. After a change in law in 2014, residents of Japan are allowed to measure HbA1c, cholesterol, and triglyceride levels by self-blood sampling from the fingers under the guidance of pharmacists. In this study, we held an event to measure the lipid levels within a community and evaluated the usefulness of a simple measurement for the early detection of dyslipidemia. Furthermore, we surveyed community members’ knowledge of dyslipidemia by self-questionnaires. Of the 48 local residents who came to the event, 45 had their lipids measured and answered the questionnaires. In 12 applicants, HDL-cholesterol or non-HDL-cholesterol, which are not affected by meals, exceeded the standard range. In the questionnaire study, 89% of applicants selected arteriosclerosis as the main consequence of dyslipidemia. Additionally, over 82% of applicants selected blue-backed fish, dietary fiber, and soybeans as food items that inhibit the rise in lipid levels. However, only 31% of applicants recognized that fruits also affect lipid levels. Although it was disappointing that 60% of applicants did not know that they could measure HbA1c and lipids at community pharmacies, 62% desired measurement of those levels in the future. This study suggested that the simple lipid measurement is useful for the early detection of dyslipidemia but local residents need to be informed about it. Furthermore, improvement in the recognition of dyslipidemia by local residents is needed.

In Japan, tuberculosis (TB) control activities are conducted by public health centres (PHCs) and treatment support is provided by public health nurses (PHNs). This study describes the TB situation in the affected areas and assesses the effectiveness of Japan’s TB control efforts after the disaster.

The purpose of the present investigation was to examine the relationships between the exercise history and the bone mineral density (BMD) and bone mineral content (BMC) in female Japanese young adults using dual X-ray absorptiometry (DXA). One-hundred twenty females, aged between 18 to 28 years, participated in the present investigation. The BMD at the lumbar spine (L-BMD), whole body BMD and BMC (WB-BMD and WB-BMC), lean body mass (LBM) and fat mass (FM) were measured by DXA. Using a self-administrered questionnaire, the exercise habits during preschool (4-6 years), primary school (7-12 years), junior high school (13-15 years), high school (16-18 years), and the current habits (>18 years) were eveluated. The L-BMD, WB-BMD and WB-BMC were significantly higher in the subjects with exercise habits during both the period of <18 years and >18 years compared with those in the subjects without an exercise history during all periods (p<0.05). In a separate analysis with the data stratified by the school age, the subjects with an exercise history during primary school, junior high school, or high school had significantly higher BMD and BMC values compared with the non-exercisers (each, p<0.05). In contrast, the BMD and BMC did not differ significantly according to either the exercise history during pre-school nor the current exercise status. A multiple stepwise regression analysis revealed that the body weight, LBM, FM, age of menarche, and exercise habits during high school were significant determinants of the L-BMD, WB-BMD and WB-BMC (p<0.001). The results of the present investigation show that both the exercise history during school age and the current exercise habits affect the BMD and BMC in young adults. In particular, high school females should be encouraged to participate in the regular exercise to increase their bone health. Future studies will be needed to confirm the targeted age-group(s) for participation in sports/exercise for the improvement of bone health, including an analysis of the type and intensity of exercise/sports.

Objectives: To clarify the preferences for survival time (ST) or quality of life (QOL) in the treatments for advanced cancer. Method: Patients with breast cancer, oncologists, and healthcare-providers including nurses, pharmacists and medical clerks were asked to anonymously complete a survey: The survey included questions regarding 1) priority among treatment options for a fictitious cancer patient, 2) preference of treatment aggressiveness for fictitious cancer patients by age group, 3) preference of treatment among options, with different weight on ST and QOL. Results: 1) Cancer patients' priority regarding ST and QOL was clearer than healthcare providers. 2) Oncologists tended to prioritize ST than cancer patients and other medical staffs in elderly patients. 3) Patients and oncologists tended to prioritize ST, whereas and other medical staffs prioritized QOL. Conclusion: Cancer patients and healthcare providers may have different perception regarding a treatment goal, which should be recognized in the practice of oncology.