An 89-year-old female was referred to her local doctor with persistent chest pain. She was rushed to our hospital because acute coronary syndrome was suspected. Emergency catheterization revealed a severe stenosis in left main trunk. An intra-aortic balloon pump (IABP) was placed, and we planned urgent surgery. During off-pump coronary artery bypass grafting, mitral valve regurgitation due to systolic anterior motion (SAM) occurred, her hemodynamics remained unstable after the operation. We performed tapering of catecholamine, and gave intravenous fluids and use of β-blocker to her. But what most improved her hemodynamics was that we removed the IABP.

Objective: The purposes of this study were to explore the actual usage of a pamphlet for families of terminally ill patients both with and without cancer at home. Methods: We sent a questionnaire to 2,000 home-visit nursing administrators and obtained answers from 430. This study included 224 pamphlet users. Results: The pamphlet was used with 95.1% of families of cancer patients and with 76.8% of families of non-cancer patients. Most pamphlet users were concerned with the following: degree of worry and anxiety of the family, and the family’s and the patient’s hope for an at home death (families of both cancer patients and non-cancer patients more than 84%). The pamphlet was given to about 60% of families of both cancer patients and non-cancer patients between last last week and last month of life. Administrators found it difficult to decide the appropriate timing to hand out the pamphlet to 59.6% of families of cancer patients and 69.7% of families of non-cancer patients. Conclusion: Pamphlet use may be improved by clarifying the appropriate timing to give out the pamphlet.

Objective: This study aimed to evaluate posttraumatic growth (PTG) from bereavement and other related factors among family members of deceased cancer patients who had been admitted to a general ward. Methods: A self-administered questionnaire was mailed to 42 bereaved family members who agreed to participate in the present study. The time from the death of their loved ones was between one and four years. Results: Of 42, 37 returned their responses. The average PTGI total score was 2.63, which was consistent with previous studies examined the scores at a general hospital and palliative care units. The PTGI was positively correlated with the emotion focus type coping, the recognition estimating support, and the emotional support. The PTGI of the bereaved whose loved ones underwent medical treatment at home was significantly higher than the score of the bereaved whose loved ones passed away at general ward. Conclusion: It is crucial to evaluate whether or not the bereaved experienced a healthy grieving process, and if they received social support. Moreover, it is important to provide the information regarding where the support is offered to the bereaved. Additionally, clinicians need to improve the support system so that the cancer patients can undergo medical treatment at home.

Objective: The purposes of this study are to explore current status and tasks of a pamphlet for families of terminally ill patients at home. Methods: We sent out the questionnaire to 419 home-visit nursing administrators, and obtained an answer from 118. Results: About 42% administrators used the pamphlet. Most pamphlet users were considering as follow: degree of worry and anxiety of the family, the family’s and the patient’s hope of being home death (each more than 82.6%). Usefulness of the pamphlet; the families could prepare for their patient’s death, understand the present condition of the patient, etc. However, 67% users were feeling difficulty to decide the timing to hand the pamphlet to the families. As a reason without the pamphlet, there are not any pamphlets available (64.1%). Conclusion: Nursing administrators who used the pamphlet have recognized the usefulness, but have felt difficulty of the use.

PURPOSE: Because the true prevalence of food allergy (FA), as based on the results of an oral food challenge test (OFC), is unknown, it is likely that children with suspected FA unnecessarily eliminate potentially causative foods. This study aimed to identify the prevalence of FA and to determine the proportion of children who unnecessarily eliminate food. METHODS: To identify children with FA, a primary survey was conducted via a questionnaire with all children aged 0-18 years in Niijima village (remote islands of Japan). In the secondary survey, a detailed medical interview was conducted by doctors with children who currently did not eat some foods. The third survey involved serum food-specific immunoglobulin E (IgE) tests and an OFC for children with suspected FA. RESULTS: Of 376 enrolled children, 374 (99.5%) completed the questionnaire. Some foods were eliminated by 18.6% and 13.0% of all children and those ≥6 years old, respectively. The target population for the secondary survey included 69 children who all completed the medical interview. The target population for the third survey consisted of 35 children, of whom 26 (74.3%) underwent the blood test. An OFC was performed 35 times with 20 children. As a result, the prevalence of FA was 4.9% in children of all ages and 4.7% in those ≥6 years old. Moreover, 55.0% children were able to cease eliminating food intake. CONCLUSIONS: It is possible that a considerable number of children unnecessarily eliminate food because of suspected FA.
Child ; Eating ; Epidemiology ; Food Hypersensitivity* ; Health Services Needs and Demand ; Hematologic Tests ; Humans ; Immunoglobulin E ; Immunoglobulins ; Islands ; Prevalence*