ABSTRACT
In order to utilize the results of genetic tests for mental and behavioral changes aimed at disease prevention, it is important to acquire the right knowledge about genetic information. Learning the basics of genetic testing and information at school may help in taking adequate precautions against illness. In this study, to improve the knowledge on central dogma (flow of genetic information) and mutation, which are the basics of genetic testing, among children in the upper grades of elementary school, we devised an illustrative video and conducted educational activities through a test-linked illustrative video lecture (TLIV lecture). In addition, the degree of comprehension and the effectiveness of the TLIV lecture were evaluated using tests conducted before and after the lecture. Both fifth and sixth graders showed a low level of comprehension (50 points or less) before the lecture. On performing the same test after the TLIV lecture, both groups showed a high degree of understanding (65 points or more), a significant increase. From the above results, it was shown that the TLIV lecture that we devised could be used as an effective tool for improving knowledge on the above-mentioned content for fifth graders and above.
ABSTRACT
Prophylaxis is sometimes offered to inpatients who share a room with, or individuals who have been in close contact with, patients who have contracted influenza. In our hospital, 5-day prophylactic oseltamivir has been used as a standard procedure. Here, we investigated the effectiveness of this post-exposure prophylaxis for inpatients and healthcare professionals, as well as its effect on hospital management. The study period was 5 years from fiscal year 2013 to fiscal year 2017, and the effectiveness outcome was the secondary infection rate. Medication costs for this prophylaxis were compared with those for oseltamivir used according to the package insert. The secondary infection rates were 3.0% and 0.5% in 133 inpatients and 434 healthcare professionals who had received post-exposure oseltamivir, respectively. The medication costs were reduced by 50% compared with the estimated costs for 10-day oseltamivir administration. The effectiveness of 5-day prophylactic oseltamivir was similar to or higher than that reported previously, indicating that this prophylaxis was effective. Moreover, 5-day post-exposure prophylactic oseltamivir is expected to reduce the prolongation of hospital stay and influenza outbreaks and thus contribute to hospital management.
ABSTRACT
<p>An epidemiological study reported that low serum cholesterol is one of the causes of cerebral hemorrhage. Furthermore, differences in the Apoprotein E (ApoE) genotype influence the amount of low density lipoprotein in serum. The value of standardized mortality ratio (SMR) for cerebral hemorrhage or infarction in residents of Kikai island (KI) is higher or lower than 100, respectively. The aim of this educational activity is to assess whether our lectures on “prevention of stroke” ─(1) relationship between cholesterol and stroke, (2) test items involved in cholesterol of serum and role of lipoprotein, (3) relationship between gene and disease, and (4) prevention of disease by diet─were effective for junior high-school students (JHS) in KI. To be improve their understanding of lecture (3), we performed genetic analysis (for ApoE polymorphism) using DNA extracted from their hair roots. Although we also conducted lectures after the results of the analysis, the pretest (40.7%) and posttest (50.0%) indicated that lecture (3) had been difficult for JHS. The total scores for the posttests for second- and third-year JHS (72.5% and 80.3%, respectively) were significantly higher than those for the pretests for second- and third-year JHS (49.6% and 55.9%, respectively). However, for first-year JHS, the total scores for posttests (63.0%) and pretests (61.7%) were not significantly different. Based on these results, we concluded that our lectures facilitated a substantial understanding about the “prevention of stroke” among JHS and were educationally beneficial for second- and third-year JHS, in particular.</p>
ABSTRACT
With the introduction of the diagnosis procedure combination (DPC) system, the reduction of the health expenditure is expected. The use of generic drugs is promoted. It is imperative for introduction of generic drugs to assure the appropriate use of drugs to decrease medical costs without reducing medical services. Additionally, we should make a concerted effort to prevent the injudicious use of antimicrobial agents resulting in the emergence of drug resistance. In this study, we assessed the effects of switching to generic antimicrobial drugs on drug purchases cost, AUD (antimicrobial use density), hospital days, and antimicrobial susceptibility of Pseudomonas aeruginosa. This study was carried out at Yashima General Hospital for the period from April 2008 to September 2011. The Health, Labor and Welfare Ministry designated Yashima General Hospital as a DPC hospital from July 2009. Since the DPC introduction, the drug purchase cost has been decreased about 40% without reduction of AUD, hospital days, and antimicrobial susceptibility of Pseudomonas aeruginosa. Hospitals are making efforts to assess and improve management efficiency while maintaining the quality of medical care. Our results suggested that the introduction of generic drugs with assessment of efficacy may be one of the useful methods for pharmacy management.
ABSTRACT
Upper gastrointestinal endoscopy is an invasive examination. Cardiovascular and respiratory adverse effects are commonly observed in patients undergoing endoscopy. We investigated prospectively the cardiovascular and respiratory changes every oneminute before, during and after routine endoscopy. Sixteen healthy adult patients were enrolled in this study. Systolic blood pressure, diastolic blood pressure, pulse rate and percutaneous arterial oxygen saturation (SpO<SUB>2</SUB>) were recorded every one-minute throughout the procedure. Systolic and diastolic blood pressure increased significantly one minute after the insertion of the endoscope. Increases in pulse rate were noted after the insertion of the endoscope. Rate pressure product increased significantly one minute after the insertion of the endoscope. No significant change in SpO<SUB>2</SUB> was observed during endoscopy. Our results indicated that upper gastrointestinal endoscopy might induce cardiovascular stress and abnormality. Therefore, we should carefully insert and manipulate upper gastrointestinal endoscope.
ABSTRACT
An 87-year-old woman with unknown fever origin was admitted to our internal department. We could not determine the fever origin from clinical findings, serious blood data, urine data, bacteriological data, and images obtained by ultrasonography, computed tomography and magnetic resonance. Body inflammatory findings did not respond to several antibiotics we used. Gallium scintiphotography revealed abnormal radioisotope uptake in the bilateral inguinal region. And ultrasonography and enhanced computed tomography showed tumors in front of the bilateral femur neck. Moreover, bone scintiphotography (<SUP>99m</SUP>Tc) revealed abnormal radioisotope uptake in the bilateral hip joints. We performed resection of the right inguinal tumor. The tumor was solid mass 30×20×20mm in size. It was covered with an articular capsule in front of the right femur neck. We identified the mass as bilateral tuberculous granulation with Langhans-type giant cells pathologically. It was only with difficulty that we firmly diagnosed the case as tuberculous arthritis of bilateral hip joints because the fever origin was unknown. It is important to diagnose tuberculous arthritis by use of various imaging techniques. We should take tuberculous infection into consideration when we encounter a case of arthritis of unknown fever origin or a case of antibiotics resistant arthritis.