ABSTRACT
The case involved a one-month-old male infant. Around two weeks after birth, cold-like symptoms were observed within the family. Over the course of approximately one month, the infant gradually developed coughing, apnea, and cyanosis, leading to a visit to a nearby medical facility. The episodes of apnea were initiated by a wet-sounding, choking cough. Respiratory pathogen multiplex screening revealed rhinovirus infection. The infant was managed in the intensive care unit and treated with a high-flow nasal cannula (HFNC), which resulted in an improvement of the recurrent episodes of apnea. We discontinued HFNC on the 7th day of hospitalization; however, the patient had recurrence of apnea. After relieving abdominal distension through rectal enema, the infant was successfully weaned off HFNC and discharged on the 14th day of hospitalization. In addition to the immaturity of the respiratory center in infants, laryngeal chemoreflex triggered by chemical receptors in the larynx is known to contribute to apnea. In the present case, we considered that the reduction of respiratory effort through HFNC, the expectorant effect of warmed and humidified air, and the decrease in gastroesophageal reflux due to alleviation of abdominal distension played roles in the successful outcome.
ABSTRACT
Objective：Only 44 of the 82 university medical schools in Japan have rehabilitation medicine departments, although rehabilitation medicine is one of the 19 basic specialties recognized by the Japanese Medical Specialty Board, and many medical doctors are concerned regarding selecting rehabilitation medicine as a basic specialty without sufficient education in the field. The “Let's Become a Physiatrist” Seminar has been organized since 2017 to eliminate such concerns, and this study aimed to investigate how these results are manifested in the number of majors.Methods：We examined the number of past attendees and tracked how many of them became rehabilitation medicine majors.Results：The number of seminar attendees over a 5-year period was 589. The number of on-demand viewers in FY2020 and FY2021, which were held via the web, was 554. A total of 116 of the 471 physicians who began specialty training in rehabilitation medicine after the seminar was planned attended or web viewed the seminar accounting for 24.63％．This percentage has been increasing each year, with 36.81％ of the majors who applied in 2022 attending the seminar, and the number of multiple attendees also increased. The number of majors has increased significantly doubling to 144 in 2022 compared with 74 in 2018.Conclusion：In many cases, the seminar helped the attendees learn more about physiatrists and develop their thoughts while attending multiple times. Thus, they started their majors. Five years have passed since we started planning this seminar, and we believe that the results are now coming to fruition.
ABSTRACT
Objective：Only 44 of the 82 university medical schools in Japan have rehabilitation medicine departments, although rehabilitation medicine is one of the 19 basic specialties recognized by the Japanese Medical Specialty Board, and many medical doctors are concerned regarding selecting rehabilitation medicine as a basic specialty without sufficient education in the field. The “Let's Become a Physiatrist” Seminar has been organized since 2017 to eliminate such concerns, and this study aimed to investigate how these results are manifested in the number of majors.Methods：We examined the number of past attendees and tracked how many of them became rehabilitation medicine majors.Results：The number of seminar attendees over a 5-year period was 589. The number of on-demand viewers in FY2020 and FY2021, which were held via the web, was 554. A total of 116 of the 471 physicians who began specialty training in rehabilitation medicine after the seminar was planned attended or web viewed the seminar accounting for 24.63％．This percentage has been increasing each year, with 36.81％ of the majors who applied in 2022 attending the seminar, and the number of multiple attendees also increased. The number of majors has increased significantly doubling to 144 in 2022 compared with 74 in 2018.Conclusion：In many cases, the seminar helped the attendees learn more about physiatrists and develop their thoughts while attending multiple times. Thus, they started their majors. Five years have passed since we started planning this seminar, and we believe that the results are now coming to fruition.
ABSTRACT
Objectives: To investigate the effect of warming on contraction of the detrusor muscle and the micturition reflex in rats. Methods: Female Sprague-Dawley rats were used in this study. Changes in the contractile response of detrusor smooth muscle strips to 40 mM KCl caused by warming to 40°C and 42°C were evaluated by an isometric tension recording study. The effect of intravesical warming at 40.7±1.0°C on the micturition reflex was evaluated by continuous infusion cystometry in conscious rats. Results: Warming to 40°C and 42°C inhibited 40 mM KCl-induced contractions of detrusor smooth muscle strips by 10% and 15.5%, respectively. Intravesical warming at 40.7±1.0°C decreased the pressure threshold for inducing micturition by 14%, resting pressure by 30%, closing peak pressure by 22%, 2nd phase contraction duration by 36%, bladder contraction duration by 26%, and increased bladder compliance by 17%. Maximal voiding pressure and 1st phase contraction duration were unaltered. Conclusions: Our results demonstrated that warming relaxed the detrusor muscle and increased bladder compliance. This suggests that warming might be useful for treatment of low compliance bladder observed in the neurogenic bladder due to neurological diseases such as spinal cord injury. To clarify the usefulness of warming or hot springs for the treatment of neurogenic bladder, the effect of warming on the body surface on the micturition reflex should be investigated.
ABSTRACT
<b>Objectives:</b> To investigate the effect of warming on contraction of the detrusor muscle and the micturition reflex in rats.<BR><b>Methods:</b> Female Sprague-Dawley rats were used in this study. Changes in the contractile response of detrusor smooth muscle strips to 40 mM KCl caused by warming to 40°C and 42°C were evaluated by an isometric tension recording study. The effect of intravesical warming at 40.7±1.0°C on the micturition reflex was evaluated by continuous infusion cystometry in conscious rats.<BR><b>Results:</b> Warming to 40°C and 42°C inhibited 40 mM KCl-induced contractions of detrusor smooth muscle strips by 10% and 15.5%, respectively. Intravesical warming at 40.7±1.0°C decreased the pressure threshold for inducing micturition by 14%, resting pressure by 30%, closing peak pressure by 22%, 2nd phase contraction duration by 36%, bladder contraction duration by 26%, and increased bladder compliance by 17%. Maximal voiding pressure and 1st phase contraction duration were unaltered.<BR><b>Conclusions:</b> Our results demonstrated that warming relaxed the detrusor muscle and increased bladder compliance. This suggests that warming might be useful for treatment of low compliance bladder observed in the neurogenic bladder due to neurological diseases such as spinal cord injury. To clarify the usefulness of warming or hot springs for the treatment of neurogenic bladder, the effect of warming on the body surface on the micturition reflex should be investigated.
ABSTRACT
Hemiplegia after a cerebrovascular event is a complication that causes problems in daily life such as difficulty of walking and may lead to social disadvantages. Furthermore, various subsequent health issues that accompany hemiplegia tend to hinder rehabilitation. In particular, Shoulder-Hand Syndrome (SHS) is an intractably painful disease with primary symptoms of pain and swelling in the upper limbs of patients. We investigated the effect of the acupuncture treatment on those patients with hemiplegia after a cerebrovascular event who are suspected to have SHS because of such symptoms as pain, swelling, and paresthesia in the upper limb of the affected side by measuring the changes in the numerical scale (NS), Gibbons' RSD score, and range of motion (ROM) in upper extremities.<br>The present study consisted of 13 hemiplegic subjects (eight males, five females) with pain, swelling, and paresthesia in the upper limbs. Acupuncture treatment was applied twice a week for over two months. Specifically electrical acupuncture and/or the retaining needle technique was applied to the upper extremities for 20 minutes in each session. Of 13 participants, 10 showed a significant decrease in NS (reduced by five or more points), eight showed improvement of the swelling in the upper limbs, and nine showed reduction in paresthesia.<br>From these results, we concluded that the acupuncture treatment was effective for SHS that accompanies hemiplegia after a cerebrovascular event and that the improvement of the peripheral blood flow might play an important role in generating treatment effects.