ABSTRACT
<b>Objective:</b> The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear. <b>Methods:</b> 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. <b>Results:</b> 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). <b>Conclusions:</b> 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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
<b>Objective:</b> The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear.<br> <b>Methods:</b> 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.<br> <b>Results:</b> 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).<br> <b>Conclusions:</b> 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.<br>
ABSTRACT
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.
ABSTRACT
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.
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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.
Subject(s)
Nocturia , Aged , SleepABSTRACT
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.
Subject(s)
Risk , LipidsABSTRACT
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.
Subject(s)
Surveys and Questionnaires , Histamine AntagonistsABSTRACT
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.
Subject(s)
SmokingABSTRACT
<b>Objective:</b> 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.<br> <b>Subjects and Methods:</b> 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.<br> <b>Results:</b> 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.<br> <b>Conclusion:</b> 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.<br>
ABSTRACT
A 46-year-old female patient with non-alcoholic steatohepatitis (NASH) was administered nateglinide, an insulin secretagogue, for 7 months, and then polyenephosphatidylcholine, an anti-oxidant medication, in accordance with the two-step hypothesis of NASH, with insulin resistance as the initial pathogenesis and oxidative stress as the second. HOMA-R, an index of insulin resistance, improved, and hepatic marker levels improved markedly by four weeks after initiation of polyenephosphatidylcholine. The beneficial effects of treatment continued over the 24 months of the study. A liver biopsy evaluated using Brunt's criteria showed improvement from stage 2 to stage 0 after 9 months. These findings suggest the therapeutic efficacy of step by step treatment of NASH in accordance with the two-stage hypothesis.
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The purpose of this study was to shed light on the prevalence of the metabolic syndrome (MetS) in a rural community and examine whether or not serum adipocytokine levels are associated with the Diagnostic Criteria for MetS and how many MetS components laid down in the standards subjects have. The subjects were 2,858 people (1,744men and 1,114 women, mean age 49.8+/-9.9 yrs) who had participated in our health screening program between April and December, 2005. After obtaining informed consent from them, we measured serum leptin, adiponectin and high-sensitivity C-reactive protein levels, while performing routine blood tests. In the present study, these measurements were used in combination with the number of MetS components applicable to the conditions of our subjects. Two hundred men (11.5%) and 25 women (2.2%) were diagnosed with MetS. The number of MetS women was extremely small. Those women who were above the standard waist circumference of above 90cm accounted for 8.7% of the total. Thus, most women subjects were excluded as MetS candidates here. The leptin levels of the MetS group were higher than those of the non-MetS group in accordance with the number of applicable components in the diagnostic standards for MetS. Especially, the MetS group which met three MetS criteria showed significantly high leptin levels (p/5=0.0081) of 5.26+/-1.86 (ng/ml) compared to 3.31+/-1.44 (ng/ml) of the non-MetS group with waist circumference below 85cm. On the other hand, no significant difference was noted between the groups in adiponectin level. However, in contrast to leptin levels, adiponectin levels were lower in the group having three MetS components than the non-MetS group 4.37+/-1.57 (ng/ml) as against 5.52+/-3.34 (ng/ml). High-sensitivity CRP levels did not show any significant difference between the two groups.As regards the cutoff value of women's waist circumference, further study needs to be done. It was suggested that serum leptin levels might be closely related to the diagnostic criteria for MetS and the number of MetS components applicable.
Subject(s)
Leptin , AdiponectinABSTRACT
This paper reports the findings of a follow-up survey on non-smoking carried out in 2005. The previous survey was conducted in 2004 by distributing questionnaires to public facilities, schools, nursery schools and post offices in Mizunami. Method:The questionnaires consisted of the same questions as the previous ones and were sent to the same 64 facilities. Results:The questionnaires were recovered from 59 facilities(92.2%). Compared with the results of the previous survey, the number of public facilities, schools, offices and resting rooms where smoking is totally prohibited increased. In post offices, smoking corners disappeared. Progress was also made remarkably in division of public space and a workplace into smoking and nonsmoking areas. The smoking ratio of employees in these facilities surveyed decreased from 20% to 17%. Conclusion:Our survey confirmed that nonsmoking has steadily won public acceptance in a matter of one year.
Subject(s)
Surveys and Questionnaires , Smoking , Schools, NurseryABSTRACT
To review the outcome of our vaccination program against influenza, an investigation was made into the incidence of this acute infectious disease in our community from 2002 through 2004.Enrolled for this retrospective study were 1) all vaccinated individuals, 2) those who underwent nasal examinations by use of the swab, and 3) patients diagnosed as contracting influenza.The number of those administered with influenza virus vaccines increased year after year during the period under review. Over 70% of them were those aged 65years or above. The mean age of those who caught influenza was 42.9±21.3 in 2002, 34.9±20.4 in 2003 and 45.4±20.2 in 2004. Compared with unvaccinated old people, many unvaccinated young and middle-aged people contracted influenza, but among the vaccinated old people, there were some who came down with the flu.Morbidity was low for the old people whose vaccination rate was high.Therefore, it can be said that vaccination was effective in achieving adequate immunity. Nonetheless, for all the preventive injection, the fact that people of advanced age could be infected should be taken note of.
Subject(s)
Influenza, Human , Vaccination , Retrospective Studies , HospitalsABSTRACT
Objective: The diagnostic criteria for the metabolic syndrome (MetS) were published in Japan in April 2005. However, there have been no large-scale studies in rural areas to confirm these criteria. We examined the prevalence of MetS in subjects who had undergone a routine medical health checkup at our hospital, located in a rural area. This data was used to investigate the appropriateness of the diagnostic criteria for MetS.Subjects and Methods: The MetS status was examined retrospectively in 2340 subjects (1408 men, 932 women ; mean age 49.6 ± 9.7 years) who underwent a routine medical health checkup at our hospital between April 2004 and March 2005.Results: Of the 1408 men and 932 women, 209 men (14.8%) and 23 women (2.5%) were diagnosed with MetS. Forty-four men (3.1%) and 4 women (0.4%) met all three diagnostic criteria for metabolic disorders. In the female group, only 8.7% of the 932 women met the waist circumference criterion of ≥90 cm. Because this waist circumference criterion was used during the first screening but was not met by most of the women, they were eliminated from our study. Using receiver operating characteristic (ROC) analysis, the cutoff values for waist circumference were 85.0 cm (sensitivity 0.750, specificity 0.564) in men and 79.5 cm (sensitivity 0.787, specificity 0.709) in women. If the women's waist circumference criterion had been set at the value of ≥79.5 cm, this would have resulted in 48 (5.2%) women meeting the criterion.Conclusion: From the viewpoint of preventive medicine, the Japanese male MetS diagnostic criteria are fairly appropriate. However, for the women, the waist circumference criterion of ≥90 cm has been set too high and was not met by most of the female subjects. Therefore, the Japanese MetS criteria for women, particularly the cutoff value for waist circumference, requires further verification.
Subject(s)
HealthABSTRACT
Objective: The purpose of this study was to evaluate the efficacy of risedronate for the improvement of the quality of life (QOL) in patients with primary osteoporosis.Methods: Twenty-seven Japanese patients who had receutly been diagnosed with primary osteoporosis (mean age: 73.8 ± 9.1yr, 18 men and 9 women) were the subjects of this study. Using the Japan Osteoporosis Society Quality of Life Questionnaire (JOQOL), each patient's QOL was evaluated before treatment with oral risedronate 2.5mg once daily, and 3, 6, and 12 months during treatment. We also measured the bone mineral density (BMD), serum bone-specific alkaline phosphatase (BAP), and serum N-terminal telopeptide of type I collagen (NTx) before treatment and at 6 and 12 months.Results: The JOQOL total score gradually increased and significantly improved after 12 months of treatment in both male (p=0.026) and female patient groups (p=0.021). The pain scores in the female group first improved significantly at 3 months (p=0.018) and continued to improve over the remaining 9 months of the study, while improvement in the male group reached a significant level at 12 months (p=0.048). Along with the improved pain scores, the other five scores (assessment of activities of daily living, entertainment and social activity, overall health, posture, and falls and anxiety) also tended to improve. Although risedronate did not significantly improve the BMD over the 12 months of this study, the serum BAP levels decreased over the 12 months period and significantly decreased in male (p=0.004) and female groups (p<0.001) at 6 months. The serum NTx level also decreased significantly in male (p=0.003) and female groups (p=0.046) at 12 months.Conclusion: The administration of risedronate for 12 months significantly improved the QOL in patients with primary osteoporosis and resulted in improved bone metabolism. The JOQOL may be an efficacious index for judging the outcome of osteoporosis treatment.
Subject(s)
Osteoporosis , Risedronic AcidABSTRACT
We experienced a clinical case of a patient with psychotic depression who ingested the residual saponated cresol solution from a 500ml bottle of cresol, a disinfectant, with the intention of committing suicide. Through this experience, we felt it neccessary to investigate the present commercial situation of cresol for domestic use, and to come up with some safty measares.All the 128 drugstores and pharmacies in four cities located in the Tohno area of Gifu Pref. (Mizunami, Toki, Tajimi and Ena) were queried by telephone about the sale and stock of cresol.Almost 80% of the drugstores in these four cities, excluding pharmacies, were found to deal in saponated cresol solutions. They carried a little more than two 500ml bottles of cresol on average. This volume exceeds an estimated adult lethal dose of 250ml.Although it is unlikely that an ordinary household will use the whole of 500ml bottle of the disinfectant at a time, the residual saponated cresol solution could increase the risk of accidental cresol poisoning at home.So, it would be desirable not to sell 500ml bottles in ordinary drugstores. Furthermore, before selling a bottle of cresol, the pharmacists, who have a specialized knowledge about it, should kindly explain to the user about its toxicity and usage.
Subject(s)
Solutions , DisinfectantsABSTRACT
An unsigned questionnaire survey of smoking was taken on all 101 students of JA Gifu Kouseiren Nurses' School. The smoking rate of the students as of July 2001 worked out at 17.8%(18 in 101 students). Most student smokers said they smoke less than 15 cigarettes a day, each containing less than 0.9mg of nicotine, and their Fagerstrom Tolerance Questionnaire (FTQ) index came to 1.94±1.51, suggesting their nicotine dependence is not so much as we thought. Almost 80% of the students who habitually smoke said they wish to quit smoking. Almost 80% of the students who do not smoke said they feel unpleasant to other person's smoking, and in contrast the remaining 20% of them said they feel like start smoking. These results suggest that there is a pressing need for advising the nurse students not to form the smoking habit and bringing the harm of smoking home to them in class.
ABSTRACT
[Background]: Fluticasone propinate (FP), an inhaled steroid agent, has greater clinical efficacy in bronchial asthma than Beclomethasone dipropionate (BDP), but it has been reported that the rate of oropharyngeal candidiasis becomes high. In this study, we evaluated the medium-term pharyngeal candidiasis rate in elderly patients after BDP was replaced with FP in maintenance therapy.<BR>[Method]: A total of 53 elderly patients 65 and over, who had previously received stable maintenance therapy with BDP, were switched to treatment with half doses of FP, and they were taught to gargle again.<BR>Eight weeks and six months later, pharyngeal swabs were taken for culture and assessment of candidiasis. These results were compared with those of 24 patients 64 and below. We also measured the inspiratory peak flow rate with inhaled FP.<BR>[Results]: Eight weeks later, candidiasis appeared in 11 patients in the advanced age group (20.8%), which was significantly high compared with only one patient in the age group under 65 (4.2%). Although the pharyngeal candidiasis of 8/11 patients became negative by teaching them thoroughly how to gargle with povidone-iodine, candidiasis appeared in another seven patients six months later, bringing the total up to 10/53 (18.9%).<BR>[Conclusion]: The appearance rate of pharyngeal candidiasis in the elderly patients, who changed for FP, was unexpectedly high. It was suggested that the frequncy of gargling after inhaling FP and the inspiratory peak flow rate when FP is inhaled could be big influential factors. When we use FP, it may be important to give medium and long term-persistent instructions to patients.