Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home / Journal of Rural Medicine

Objective: We aimed to clarify factors associated with the ability to seek help among older male caregivers who care for women with dementia in their families.Patients and Methods: This information will inform strategies to support their continued provision of long-term care. Participants were 364 male caregivers recruited from three places: The study period was 2017–2018. We obtained ethical approval for this study from the relevant ethics committee.Results: The ability to seek help for care problems among male caregivers was normally distributed. We found that more than 90% of older male caregivers did not actively seek help to resolve care problems, suggesting that older male caregivers had problems with long-term care. In the high score group, health status and the number of emotional support persons in the household were significantly and somewhat strongly positively correlated. The low score group showed a significant and rather weak positive correlation between economic status and health status, and the number of emotional supporters inside and outside the household.Positive correlations for the high score group were self-esteem and depressive symptoms, and self-esteem and resources. Positive correlations for the low score group were self-esteem and depressive symptoms, self-esteem and resources, and resources and depressive symptoms.Conclusion: Male caregivers are more likely to seek help if they are employed or play a role in their community. Nurses also need to support male caregivers with positive words and praise to help them use available support and resources and continue to provide long-term care. It is important for healthcare professionals to observe whether a caregiver presents with depressive symptoms or has long-term care problems because older male caregivers do not seek help. Collaboration between caregivers and medical, long-term care, and welfare professionals is necessary. Direct and timely intervention is needed.

Comparative Study of the Safety Information in the Private Import through the Internet of the Melatonin from which a Classification between Drugs and Food Differs in Japan and the United States / 社会薬学

Classification of food and pharmaceutical products are different. In the proper use of pharmaceutical products, it is essential for a medical consumer to receive the drug information about effectiveness, safety and quality of it. On the other hand, since legal classification between medicines and dietary supplements was based their cultures, the classification of each drug is different in each country. Melatonin is a hormone produced by the pineal gland and used for improvement of the jet lag. We searched melatonin product information of Japan and the United States by using Internet search mainly and investigated the relationship between amount of product information and product classification. Melatonin is classified as a dietary supplement in the United States, the product information of efficacy and safety is displayed as “Supplement Facts” and the use of melatonin in children is not recommended. On the other hand, melatonin is classified as a pharmaceutical product in Japan, but is not produced in Japan. Therefore, it is difficult to have it for Japanese customers, and then they personally import using the Internet with their self-responsibility. However it is difficult to obtain its appropriate information for consumers, because of the regulation of the Pharmaceutical Affairs Law. It has been reported that the poisoning accident by the excessive intake of melatonin already. It will increase the risk of the health problem to purchase melatonin through the Internet more. Therefore, we concluded that Internet purchase of Medicines had a high risk for Japanese customers since there was not sufficient drug information.

Pervasive Developmental Disorders and Autism Spectrum Disorders: Are These Disorders One and the Same?

The concept of pervasive developmental disorders (PDD) and autism spectrum disorders (ASD) closely resemble each other. Both ICD-10 and DSM-IV use the term PDD. The authors surveyed the perception of PDD/ASD and attitudes toward terminology. The subjects of this study were 205 medical/social-welfare professionals working in fields relating to developmental disorders. Questionnaires were mailed to site investigators at the collaborating institutes. With regard to what the scope of ASD and PDD encompasses, the answers were almost equally divided among three views: ASD and PDD are the same, PDD is wider in scope and ASD is wider. The terms PDD and autism were used in slightly different ways depended upon the situation. Our results demonstrate that the parameters of PDD and ASD are unclear and that the terms related to PDD/ASD are often used differently. Further studies are required to develop more clear and reliable diagnostic criteria for PDD.

Successful Surgical Correction of an Incomplete Endocardial Cushion Defect in an Elderly Patient / 日本心臓血管外科学会雑誌

A successful surgical correction of an incomplete endocardial cushion defect (ECD) with an ostium primum defect in a 63-year-old man is reported. Incomplete ECD with ostium primum defect often causes severe heart failure in infancy. Reports of its surgical correction in elderly patients are few. The patient had upper abdominal discomfort and grade 1 mitral valve regurgitation. The preoperative diagnosis was complete ECD (Rastelli type A) because we misdiagnosed a leakage from a cleft between the left superior leaflet and the left inferior leaflet for a flow through a ventricular septal defect when we analyzed a preoperative left ventriculography. The importance of not misdiagnosing the leakage and echocardiography in preoperative diagnosis of ECD was therefore realized. The operative procedure involved patch closure of the ostium primum defect and mitral valve annuloplasty by Kay's procedure and the mitral valve regurgitation completely disappeared. The postoperative course was uneventful. The upper abdominal discomfort and cardiomegaly improved. If there is no severe dysfunction of other organs, surgical correction of incomplete ECD should be recommended even for elderly patients.