Purpose: The purpose of this study was to acquire integrated views from previous studies on what interventions by rehabilitation specialists have led to the reduction of the care burden for stroke survivors' families.Method: Reported randomized controlled trials concerning interventions for the care burden of stroke survivors' families by rehabilitation specialists were extracted from two electronic databases, and their content was assessed by a systematic review.Results: Among the 11 analyzed studies, no studies focused on the stroke survivors' families. Studies reporting a reduction in the care burden were those comparing the presence of botulinum therapy and those comparing occupational therapy and non-intervention.There were no significant differences in the care burden for stroke survivors' families between the interventions by rehabilitation specialists and standard rehabilitation.Conclusion: Interventions for stroke survivor's families by rehabilitation specialists do not reduce the care burden in comparison with standard care.

Purpose: To clarify intervention methods used by medical professionals in clinical situations and their effects on the health literacy of patients.Method: Reports on randomized controlled trials for the health literacy of patients were collected from the electronic database. The reports were then evaluated using qualitative systematic reviews conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.Result: On examination of the effects by intervention methods, we found that many reports concluded an improvement in health literacy by patients by "only the distribution of handouts". Moreover, many reports also noted improved "adherence for health behavior" by patients following the "distribution of handouts and explanation by medical professionals". Furthermore, improved "health literacy" by "one-way intervention from medical professionals to patients" and "two-way intervention by both medical professionals and patients" was reported.Conclusion: Based on this study, it may be possible to provide information considering individuality when the medical professional provides an explanation to the patient in addition to giving handouts. Improved disorder comprehension and self-management skills are expected when the medical professional appropriately confirms the patient's comprehension level.

College athletes often tend to suffer from defective nutrition status due to excessive physical training with inadequate dietary intakes, which resulted in various physical disorders such as anemia. This study was conducted to investigate the effects of nutrition interventions to the anemic state of long distance runners. A nutritional education program was applied and daily single pack of nutritional supplement drink rich in iron, zinc, copper, selenium as well as eleven vitamins were provided for two months. Blood hemoglobin, red blood cells as well as serum ferritin and iron levels after the intervention were significantly higher compared with the basal, pre-intervention level of respective items. Among the subjects, two were found to be anemic (hemoglobin<13g/dl) before the intervention. Both of them, however, were successfully recovered to normal status (hemoglobin≧13g/dl) thereafter. The pre-intervention levels of hemoglobin were negatively correlated to the amount of difference between those of pre- and post-intervention, which appeared to indicate an improvement of nutrient deficiency that caused the hypochromia. On the other hands, the intake of energy and nutrients from meals did not change before and after the intervention. From the results obtained, it seems to be appropriate to emphasize the importance of nutrition education, especially, a possible effectiveness of including multiple nutrient supplementation in nutrition program for college athletes is suggested.

We report a patient who was successfully treated with a herbal formulation of goreisan (Wu-ling-san) for recurrent vomiting associated with pyloric stenosis, with significant simultaneous improvement of congestive heart failure.
A 78-year-old woman was in a bedridden state after cerebral infarction and was being fed through a nasal tube. She often experience repeated vomiting and aspiration pneumonia. Cicatricial stenosis was found in the pyloric region and we performed an expansion operation with balloon endoscopy. However, symptoms did not improve and her heart failure worsened. Therefore, we administered goreisan. Urinary output volume increased, edematous changes gradually disappeared, and pleural effusion decreased. The stenosis-related lesion did not change, but the vomiting ceased, even after nasal tube feeding was resumed.
Goreisan is an herbal formula used to promote diuresis that is considered to correct water absorption in digestive organs. In this case, goreisan was effective for the improvement of many symptoms.

We report a case of chronic heart failure with hypotension, successfully treated with goreisan (Wu lin san).In this case, goreisan improved both the heart failure symptoms and water regulation. This 91-old woman had been receiving treatment for congestive heart failure, mitral regurgitation, aortic regurgitation and atrial fibril lation, and had undergone pacemaker implantation due to sick sinus syndrome. She underwent repeated hospi talization due to aggravation of her chronic heart failure. She was re-admitted because of systemic edema as well as exacerbation of heart failure symptoms which included pleural effusions. Blood pressure remained constant at about 80/50 mmHg. She was prescribed furosemide 40 mg. Thereafter, cerebral infarction compli cations arose. Therefore, it became difficult to increase the quantity of diuretics. We administered goreisan without change to the other oral medications. Many of her symptoms improved and the pleural effusion resolved without affecting blood pressure.
Goreisan is one representative herbal formula for promoting diuresis. In this case, it is thought that goreisan showed actions that influenced water regulation.

The purpose of this study was to evaluate the effect of keishibukuryogan (KB) against the cognitive symptoms associated with silent brain infarction in a prospective cohort study. The subjects were 93 patients with silent brain infarcts who visited the Department of Japanese Oriental Medicine, University of Toyama, and its allied hospitals. They consisted of 24 males and 69 females, mean age (± S.E.) 70.0±0.8.Group SK (n=51) consisted of patients who used KB extract for more than6months per year. Group SC (n=42) consisted of patients who did not use Kampo formulas. The NS group (n=44) consisted of elderly subjects who had no silent brain infarction, 21 males and 23 females, with a mean age (± S.E.) of 70.7±0.7 years. Among the three groups, the revised version of Hasegawa's dementia scale, apathy scale and self-rating depression scale were compared between the study start and after three years. In the SK and SC groups, these scores, and the subjective symptom levels (head heaviness, headache, dizziness or vertigo, stiff shoulder) were also studied. The results showed that the self-rating depression scales at study start for the SK and SC groups were significantly higher compared to the NS group. In spite of the scores for the NS group increasing after three years, the SK group scores were significantly decreased compared to the SC and NS groups. KB was effective against head heaviness, which often complicates silent brain infarction. In the above mentioned, KB was effective in treating cognitive disorders and subjective symptoms related to silent brain infarction.
Infarction ; Brain ; seconds ; Ions ; symptoms <1>

The objective of this study was to examine whether the combination of n-3 polyunsaturated fatty acids PUFA) supplementation and physical exercise training would decrease oxidative stress in comparison with n-3 PUFA supplementation only in humans. Eighteen women college students were divided into a perilla oil supplemented control group or a perilla oil supplemented physical exercise trained group throughout the experimental period of 4 weeks. After the intervention in both groups, plasma triglyceride levels were decreased. Serum thiobarbituric acid reactive substances (TBARS) level in the control group was increased by n-3 PUFA supplementation. In the trained group, however, TBARS level was unchanged. Plasma vitamin C level in the trained group was significantly decreased by n-3 PUFA supplementation. These results suggest that the combination of n-3 PUFA supplementation and physical exercise training might result in attenuated tissue damage induced by reactive oxygen species, if appropriate daily antioxidants, especially vitamin C, were provided.

The purpose of this study was to assess the status of nutrients intake in male Japanese collegiate athletes. Each 20 of baseball (B), soccer (S), volley ball (V), and long distance (L) athletes participated in this study. The B, S, and V athletes lived by themselves, whereas the L athletes lived in an athletes dormitory with provided meal. The nutritional status was assessed for 2 days. Mean energy intakes in the B, S, V, and L groups were 43.6, 53.7, 47.0, and 55.0 kcal/kg body weight, respectively. Mean protein intakes were 1.2, 1.6, 1.3 and 2.4 g/kg, respectively. In B athletes, skipping of breakfast was recognized frequently. Most of micronutrients intakes in the B, S, and V groups were less than the recommended dietary allowances for athletes. We suggest that a provided meal system is a better system for collegiate athletes and more nutritional education is necessary for Japanese male collegiate athletes, in particular, those living by themselves.

N-3 polyunsaturated fatty acid supplementation has been recognized to affect the peripheral oxygen delivery system with increasing blood rheology. The purpose of the present study was to investigate whether n-3 polyunsaturated fatty acid supplementation, using purified perilla oil rich in α-linoleic acid, improves aerobic capacity in young women. Eighteen young, sedentary female college students were divided into an n-3 polyunsaturated fatty acid supplemented control group (PUFA-C, n=10) and an n-3 polyunsaturated fatty acid supplemented trained group (PUFA-T, n=8). All subjects took 20g of perilla oil (11g of n-3 polyunsaturated fatty acid) in addition to the usual diet throughout the experimental period of 4 weeks. PUFA-T subjects exercised for 30 min on a bicycle ergometer (intensity, 60% of VO₂max) 4 times a week for 4 weeks. Maximal oxygen uptake (VO₂max) and oxygen uptake at the ventilatory anaerobic threshold level (VT) significantly (p<0.05) increased after treatment in both groups. However, the endurance time in the exhaustive exercise test significantly (p<0.05) increased in the PUFA-T group only. Increasing rates of VO₂max and VT with treatment for the PUFA-C group were lower than those for the PUFA-T group (VO₂max, 12.6% vs 14.4%, VT, 9.7% vs 16.9%). After treatment, these values returned to baseline levels within 2 months of the recovery period without n-3 polyunsaturated fatty acid supplementation in both groups. Only for the PUFA-T group, VO₂max and VT at 2 months after the treatment period were significantly (p<0.05) higher compared with baseline levels. These results suggest that n-3 polyunsaturated fatty acid supplementation might have a beneficial effect on improving aerobic capacity with increasing peripheral oxygen delivery. However, n-3 polyunsaturated fatty acid supplementation was less effective than aerobic training.

Nutritional profiles in middle-aged trained and untrained women were compared both before and after menopause. Subjects were assigned to one of four groups : (1) pre-menopausal trained (Pre-T: n=14, aged 43±5 years, running distance 56±27 km/week, Vo₂max 49±4ml/ kg/min, mean±SD), (2) pre-menopausal untrained (Pre-UT: n=25, 42±5 years, 34±5 ml/kg/ min), (3) post-menopausal trained (Post-T: n=19, 53±3 years, 49±17 km/week, 42±6 ml/ kg/min), (4) post-menopausal untrained (Post-UT: n=26, 54±3 years, 31±3 ml/kg/min) . There were no significant differences in hematocrit (range 38.7 to 39.3%), hemoglobin (12.8 to 13.1 g/dl) and total protein (6.9 to 7.1 g/dl) among the four groups. Serum iron concentrations in the post-menopausal women (Post-T: 97±30μg/dl, Post-UT: 106±29μg/dl) were relatively higher than in the pre-menopausals (Pre-T: 85±35 pg/dl, Pre-UT: 78±33 pg/dl) . Mean total iron binding capacity in Post-UT (326 pg/dl) was lower than other groups (352 to 361 pg/dl) . Higher serum ferritin levels were observed in the post-menopausal women (Post-T : 35.8±27.5 ng/ml, Post-UT : 60.4±47.1 ng/ml) than the pre-menopausals (Pre-T: 18.3±13.1 ng/ml, Pre-UT: 16.6±10.7ng/ml) . Intake levels of the four groups with regard to the major nutrients were sufficient as compared with the recommended dietary allowance appropriate for age, sex and physical activity level. Intakes of calcium, iron and vitamins B₁, B₂ and niacin were higher in the trained groups than in the untrained. Regularly performed endurance exercise resulted in higher protein and iron intakes associated with higher energy intakes both before and after menopause. These results suggest that nutritional status of middle-aged women who regularly perform vigorous endurance running could be adequate for maintaining their health in a good state.