Purpose and Background: To attain the goal of the “Operation Zero Asthma Death” implemented by the Ministry of Health, Labor and Welfare, it is essentially important to make the treatment guidelines known widely and make proper use of inhaled steroid drugs at an early stage. That said, in the area where specialists are in extremely short supply, there are limitations to the development of the operation. The Asthma Control Committee organized by the Tono Chapter of the Medical Association in Gifu Prefecture developed a four-layered system of its own for coordination between hospitals, clinics, drug stores and public care facilities. This year is the third year after the system was worked out. In the present study, we examined the results of the asthma control activities. Methods;In the first layer, hospitals and clinics jointly hold lecture meetings to familiarize the treatment guidelines through asthma cards;in the second layer, medical specialists and pharmacists held inhalation workshops for pharmacists in neighborhood drugstores; in the third layer, emergency paramedics joined forces, and in the forth layer, the aim was to build up a collaborative relationship with nursing care workers. The effects of these activities using the four-layered system on the Operation Zero Asthma Death were assessed in terms of the amount of inhaled steroid drugs prescribed and the change in the number of asthma deaths per 100,000 persons. Results: The amount of inhaled steroid drugs prescribed increased almost twice as much as before the start of these activities. It was found that the inhalation workshops were attended by almost all the druggists in the district, thus laying the foundation for the system of inhalation instruction. Through the nursing care support seminars, the collaborative relationship was established. The open lecture meeting held twice for ordinary people were very well attended, thus playing an important role in increasing the knowledge of asthma among the general public. The asthma deaths in the Tono district dramatically decreased from 4.13/100,000 persons for 1998 to 0.81/100,000 for 2008. The death ratio for 2008 was compared favorably with 1.17/100,000 in the whole prefecture for the same year. Conclusion: The results clearly indicated that the four-layered system worked out by the Asthma Control Committee could surely reduce the number of deaths from asthma even in the area where specialists are in short supply.

  Purpose and Background: To attain the goal of the “Operation Zero Asthma Death” implemented by the Ministry of Health, Labor and Welfare, it is essentially important to make the treatment guidelines known widely and make proper use of inhaled steroid drugs at an early stage. That said, in the area where specialists are in extremely short supply, there are limitations to the development of the operation. The Asthma Control Committee organized by the Tono Chapter of the Medical Association in Gifu Prefecture developed a four-layered system of its own for coordination between hospitals, clinics, drug stores and public care facilities. This year is the third year after the system was worked out. In the present study, we examined the results of the asthma control activities. Methods;In the first layer, hospitals and clinics jointly hold lecture meetings to familiarize the treatment guidelines through asthma cards;in the second layer, medical specialists and pharmacists held inhalation workshops for pharmacists in neighborhood drugstores; in the third layer, emergency paramedics joined forces, and in the forth layer, the aim was to build up a collaborative relationship with nursing care workers. The effects of these activities using the four-layered system on the Operation Zero Asthma Death were assessed in terms of the amount of inhaled steroid drugs prescribed and the change in the number of asthma deaths per 100,000 persons. Results: The amount of inhaled steroid drugs prescribed increased almost twice as much as before the start of these activities. It was found that the inhalation workshops were attended by almost all the druggists in the district, thus laying the foundation for the system of inhalation instruction. Through the nursing care support seminars, the collaborative relationship was established. The open lecture meeting held twice for ordinary people were very well attended, thus playing an important role in increasing the knowledge of asthma among the general public. The asthma deaths in the Tono district dramatically decreased from 4.13/100,000 persons for 1998 to 0.81/100,000 for 2008. The death ratio for 2008 was compared favorably with 1.17/100,000 in the whole prefecture for the same year. Conclusion: The results clearly indicated that the four-layered system worked out by the Asthma Control Committee could surely reduce the number of deaths from asthma even in the area where specialists are in short supply.

  Purpose and Background: To attain the goal of the “Operation Zero Asthma Death” implemented by the Ministry of Health, Labor and Welfare, it is essentially important to make the treatment guidelines known widely and make proper use of inhaled steroid drugs at an early stage. That said, in the area where specialists are in extremely short supply, there are limitations to the development of the operation. The Asthma Control Committee organized by the Tono Chapter of the Medical Association in Gifu Prefecture developed a four-layered system of its own for coordination between hospitals, clinics, drug stores and public care facilities. This year is the third year after the system was worked out. In the present study, we examined the results of the asthma control activities. Methods;In the first layer, hospitals and clinics jointly hold lecture meetings to familiarize the treatment guidelines through asthma cards;in the second layer, medical specialists and pharmacists held inhalation workshops for pharmacists in neighborhood drugstores; in the third layer, emergency paramedics joined forces, and in the forth layer, the aim was to build up a collaborative relationship with nursing care workers. The effects of these activities using the four-layered system on the Operation Zero Asthma Death were assessed in terms of the amount of inhaled steroid drugs prescribed and the change in the number of asthma deaths per 100,000 persons. Results: The amount of inhaled steroid drugs prescribed increased almost twice as much as before the start of these activities. It was found that the inhalation workshops were attended by almost all the druggists in the district, thus laying the foundation for the system of inhalation instruction. Through the nursing care support seminars, the collaborative relationship was established. The open lecture meeting held twice for ordinary people were very well attended, thus playing an important role in increasing the knowledge of asthma among the general public. The asthma deaths in the Tono district dramatically decreased from 4.13/100,000 persons for 1998 to 0.81/100,000 for 2008. The death ratio for 2008 was compared favorably with 1.17/100,000 in the whole prefecture for the same year. Conclusion: The results clearly indicated that the four-layered system worked out by the Asthma Control Committee could surely reduce the number of deaths from asthma even in the area where specialists are in short supply.

  Purpose and Background: To attain the goal of the “Operation Zero Asthma Death” implemented by the Ministry of Health, Labor and Welfare, it is essentially important to make the treatment guidelines known widely and make proper use of inhaled steroid drugs at an early stage. That said, in the area where specialists are in extremely short supply, there are limitations to the development of the operation. The Asthma Control Committee organized by the Tono Chapter of the Medical Association in Gifu Prefecture developed a four-layered system of its own for coordination between hospitals, clinics, drug stores and public care facilities. This year is the third year after the system was worked out. In the present study, we examined the results of the asthma control activities. Methods;In the first layer, hospitals and clinics jointly hold lecture meetings to familiarize the treatment guidelines through asthma cards;in the second layer, medical specialists and pharmacists held inhalation workshops for pharmacists in neighborhood drugstores; in the third layer, emergency paramedics joined forces, and in the forth layer, the aim was to build up a collaborative relationship with nursing care workers. The effects of these activities using the four-layered system on the Operation Zero Asthma Death were assessed in terms of the amount of inhaled steroid drugs prescribed and the change in the number of asthma deaths per 100,000 persons. Results: The amount of inhaled steroid drugs prescribed increased almost twice as much as before the start of these activities. It was found that the inhalation workshops were attended by almost all the druggists in the district, thus laying the foundation for the system of inhalation instruction. Through the nursing care support seminars, the collaborative relationship was established. The open lecture meeting held twice for ordinary people were very well attended, thus playing an important role in increasing the knowledge of asthma among the general public. The asthma deaths in the Tono district dramatically decreased from 4.13/100,000 persons for 1998 to 0.81/100,000 for 2008. The death ratio for 2008 was compared favorably with 1.17/100,000 in the whole prefecture for the same year. Conclusion: The results clearly indicated that the four-layered system worked out by the Asthma Control Committee could surely reduce the number of deaths from asthma even in the area where specialists are in short supply.

Objective: The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear. Methods: Fifty nondiabetic patients with untreated mild hypertension were randomly assigned to telmisartan (40 mg/day) and valsartan (80 mg/day) groups and were switched in a crossover manner at 3-month intervals. Serum leptin, adiponectin, hsCRP and the HOMA-R were measured before and at 3 months during each treatment period. Results: The HOMA-R significantly improved over the 3 months in the high insulin resistance group (HOMA-R>/=2.5) during the telmisartan treatment period (p=0.042), but not during the valsartan period. Both telmisartan and valsartan significantly decreased serum leptin levels in each female group during each treatment period (p<0.001 and p<0.001, respectively), but not in the male groups. Serum adiponectin did not increase in either treatment group. Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively). Conclusions: Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

Objective: The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear.
Methods: Fifty nondiabetic patients with untreated mild hypertension were randomly assigned to telmisartan (40 mg/day) and valsartan (80 mg/day) groups and were switched in a crossover manner at 3-month intervals. Serum leptin, adiponectin, hsCRP and the HOMA-R were measured before and at 3 months during each treatment period.
Results: The HOMA-R significantly improved over the 3 months in the high insulin resistance group (HOMA-R>/=2.5) during the telmisartan treatment period (p=0.042), but not during the valsartan period. Both telmisartan and valsartan significantly decreased serum leptin levels in each female group during each treatment period (p<0.001 and p<0.001, respectively), but not in the male groups. Serum adiponectin did not increase in either treatment group. Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).
Conclusions: Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

Aim and background: Chronic insomnia in elderly patients significantly affects their health and quality of life (QOL). Nocturia also worsens sleep condition. The aim of this study was to evaluate the improvement effects of quazepam, a long-term acting benzodiazepine, on insomnia and nocturia in elderly patients. Method: Forty-one elderly outpatients (mean age 77.1 ± 5.6 yr) suffering from chronic insomnia while on regular a short- or ultra-short-acting hypnotic treatment were enrolled. We prescribed 7.5-15 mg of quazepam, which was administered regularly by the subjects before bedtime. A questionnaire was used to compared changes in quality of sleep and frequency of nocturia for before treatment and at 2 and 4 weeks after initiation of treatment. QOL was also examined using the 36-item Short Form Health Survey of the Medical Outcomes Study (SF-36). Results: Thirty-seven subjects (90.2%) completed the study. All subscales of the sleep quality questionnaire improved significantly (p<0.001) after 2 weeks, as did the total scores (p<0.001) after 4 weeks. Frequency of nocturia decreased significantly from 3.6 ± 1.7 times to 1.5 ± 0.8 (p<0.001) and 1.2 ± 1.0 times (p<0.001) after 2 and 4 weeks, respectively. Every SF-36 subscale also showed significant improvement after 4 weeks. The total SF-36 scores of the group showing a decrease in the frequency of nocturia (>/= 2 times) improved significantly compared with that with a frequency of < 2 times (p=0.016). Conclusion: Quazepam significantly improves sleep, QOL and nocturia in elderly patients that respond poorly to short-acting or ultra-short-acting hypnotics.
Nycturia ; Elderly ; week ; lower case pea ; Sleep

Background/Objectives: Since April 2006, smoking cessation treatment has been included in public health insurance coverage, although conditionally. The tobacco control program usually takes 12 weeks or so. When it comes to the form of treatment, most medical care facilities adopt nicotine replacement therapy (NRT) at their outpatient ward. The cessation success rates are considered not so high as before. In stead of treating nicotine-addict outpatients individually, our hospital has been offering a stop-smoking program all its own since 1999. This study was designed to examine the results of our efforts in the last six years retrospectively.Subjects/Methods: Enrolled for this study were 232 patients who had participated in our six-month smoking cessation program between 1999 and 2005. A non-smokingsupport team made up of a physician, pharmacist(s), nurses, dietitian(s) and physical therapist(s) takes care of groups of participating patients, each group consisting of 10 or less. The patients undergo behavior therapy throughout the 6-month period and NRT in the first eight weeks. Under the program, nutrition guidance is offered regularly by dietitians for weight control and physical exercises by physical therapists for relief from the stress due to abstinence from smoking. We took a questionnaire survey of all the subjects and worked out the ratios of those persons who had remained abstinent up to one year after they stopped smoking to the total.Results: The rates of abstinence maintained eight weeks, six months and one year after the start of cessation were 78.4%, 70.3% and 64.7%, respectively. Of those who were still abstinent, 78.0% replied that they found it easy to resist the urge to smoke cigarette thanks to the smoking cessation program.Conclusion: Our six-month participatory tobacco control program was found effective as high cessation rates were maintained.
Cessation of smoking ; seconds ; month ; week ; Smoking

Purpose: Many types of antihistamines used for the treatment of allergic rhinitis induce drowsiness as a side effect. Whether or not patients taking the internal drugs know of this untoward effect is a matter of importance. Recently we conducted a questionnaire survey to know how many patients are aware of this.Method: The subjects were 257 patients who visited our hospital for treatment of alergic rhinitis and took the prescription from February through March this year. The patients filled in a questionnaire given at the window of the dispensary. All the participants in this survey gave their informed consent.Results: Effective replies (90.3%) were obtained from 232 patients (mean age: 53.5±17.5; sex: 85 males and 147 females). Of those respondents, 45 individuals (19.9%) said they did not know that the antihistamines produce drowsiness. Furthermore, the survey found that 24 out of the 45 individuals were actually taking the type of antihistamine that caused drowsiness and 21 individuals were not given any explanation of the side effect by their doctors. The patients said that if they knew of the side effect they would not have taken the medicine. Moreover, it was found that 10 out of the 21 patients drove their cars while they felt drowsy.Conclusions: The survey revealed the hard fact that the drowsiness as side reaction the patients might have after taking antihistamines was made light of. The findings brought home to us the importance of giving clear directions to the patients about the medicine and the precaution against the side effects.
Drowsiness ; Surveys ; Antihistamines ; adverse effects ; Effective

Objective: The aim of the study was to assess the effect of rosuvastatin 2.5 mg, an inhibitor of HMG-CoA reductase, on achieving lipid goals defined by the 2007 Japan Atherosclerosis Society guidelines. Subjects and Methods: Thirty-seven patients with moderate to high risk hypercholesterolemia (Mean age: 64.8 ± 8.4) were treated with 2.5 mg/day of rosuvastatin and their lipid and hepatic function parameters were measured at the baseline and at Weeks 4 and 8. Results: At 4 and 8 weeks after start of treatment, 74.1% and 92.6% of moderate risk patients, as well as 70% and 80% of high risk patients, achieved their LDL-C goals, respectively. In both moderate and high risk patients, the mean LDL-C/HDL-C ratio, which is considered as a prospective index for plaque regression, was significantly reduced (p<0.001 for both the moderate and high risk groups), and the mean LDL-C/HDL-C ratio decreased to less than 2 in moderate risk patients. No abnormal changes were observed in hepatic function tests during the study. Conclusion: More than 80% of moderate to high risk patients with hypercholesterolemia achieved their lipid goals and the mean LDL-C/HDL-C ratio was significantly reduced after the 8-week short treatment of rosuvastatin 2.5 mg, suggesting the clinical possibility of continuous use of rosuvastatin for plaque regression.
Carbon ion ; Risk ; Lipids ; Low density lipoprotein cholesterol measurement ; High density lipoprotein measurement