Objective: The package inserts are official clinical decision-making documents that provide pharmacological treatment information. However, it has been noted that package inserts on perinatal drug usage differ greatly from expert opinions. This study identified Japanese package insert drugs that are contraindicated for pregnant women and compared them to foreign risk categories.Methods: The survey included 19,022 drugs on the drug pricing list as of April 2022, with package inserts available on the Pharmaceuticals and Medical Devices Agency website. We retrieved the package inserts with the word “pregnant” in the “Contraindications” section and reviewed the descriptions to exclude those that satisfied the exclusion criteria. We also checked the foreign risk categories of contraindicated ingredients for pregnant women. This study used the Australian Therapeutic Goods Administration’s categorization for prescribing medicines in pregnancy (the TGA classification).Results: Of the 19,022 medicines studied, 4,111 (21.6%) were contraindicated for pregnant women. Conversely, 19 (5.1%) ingredients categorized under the relatively safe TGA classifications A, B1, and B2 were also contraindicated for pregnant Japanese women.Conclusion: This study revealed that Japanese package inserts contraindicate over 20% of drugs for pregnant women. On the other hand, some forbidden ingredients did not match the foreign risk categories. Therefore, healthcare professionals should be aware of the limitations of Japanese package inserts concerning pregnant women and make careful decisions based on both package inserts and additional drug information.

A 79-year-old woman with left hemiplegia and loss of consciousness was transferred to a previous hospital. She underwent a CT-scan of the aorta and CT-perfusion of the brain and was diagnosed with Stanford type A acute aortic dissection complicated with cerebral malperfusion with narrowing of the right carotid artery region. She was transferred to our hospital and underwent emergency ascending aorta replacement. Preoperative CT perfusion findings predicted improvement of neurological symptoms after aortic repair, and she had no neurological complications postoperatively.

[Objective]To investigate the effects of acupuncture on sports activities of athletes[Methods]A total of 1,804 athletes were targeted. The method used was a collective survey. Questionnaires were administered after obtaining consent from the participants; online questionnaires were also provided. The questionnaire evaluated profile (sex, age); sensation immediately after acupuncture treatment, duration of stimulus sensation, stimulus intensity, stimulus sensation, and therapeutic effect; timing of acupuncture treatment; and questions related to acupuncture as to whether the acupuncture caused any adverse effects on play (movement) or showed any positive effects.[Results]In total, 1,525 (84.5%) valid responses were obtained. The survey analyzed 841 subjects (55.1%) who underwent acupuncture. The most common response after acupuncture treatment was that the subjects felt lighter and were able to move more easily; 43.9% of subjects gave this response. In addition, 10.6% of respondents said that they continued to feel pain similar to the sensation during acupuncture treatment and 7.7% said they felt weak. The most common response at 59.8% was that the sensation felt during acupuncture disappeared quickly after treatment was ended, 58.6% of subjects said that the sensation felt after acupuncture was optimal, and 48.3% responded that the sensation from treatment remained and a positive effect was observed. The most common timing for receiving acupuncture for 21.8% of subjects was after practice or a match: [Discussion and Conclusion]Acupuncture for athletes should be performed according to the guidelines, taking into account the competition schedule and type of competition and the appropriate amount of acupuncture stimulation, thereby preventing problems during competition.

[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.

The goal of the present study was to test the reliability and validity of the Japanese version of the Quality of Life after Brain Injury (QOLIBRI) scale. Correlations between the QOLIBRI and Glasgow Coma Scale scores, anxiety, depression, general quality of life (QOL), and demographic characteristics were examined to assess scale validity. The structure of the QOLIBRI was investigated with exploratory and confirmatory factor analyses, as well as the Partial Credit Model. Test–retest reliability was assessed over a 2-week interval. Participants were 129 patients with traumatic brain injury (TBI) recruited from rehabilitation centers in Japan. The QOLIBRI showed good-to-excellent internal consistency (Cronbach's α: 0.82–0.96), test–retest reliability, and validity (r = 0.77–0.90). Factor analyses revealed a 6-factor structure. Compared to an international sample (IS), Japanese patients had lower QOLIBRI scores and lower satisfaction in several domains. There were positive correlations between the QOLIBRI scales and the Short Form 36 Health Survey (r = 0.22–0.41). The Japanese version of the QOLIBRI showed good-to-excellent psychometric properties. Differences between JS and IS may reflect sampling bias and cultural norms regarding self-evaluation. The QOLIBRI could be a useful tool for assessing health-related QOL in individuals with TBI.
Anxiety ; Asian Continental Ancestry Group ; Brain Injuries ; Brain ; Depression ; Diagnostic Self Evaluation ; Glasgow Coma Scale ; Health Surveys ; Humans ; Japan ; Psychometrics ; Quality of Life ; Rehabilitation Centers ; Reproducibility of Results ; Selection Bias ; Weights and Measures