ABSTRACT
<b>Objective：</b>There are few reports on decision-making support at palliative care clinics in designated regional cancer care hospitals. This study clarified the types of decisionmaking support patients with cancer and their families were provided by specialized outpatient palliative care services.<b> Method：</b>We retrospectively examined the medical records of 110 patients who had been referred to the palliative care clinic for home care between April 2012 and March 2014. <b>Results：</b>The median duration of receiving services from the palliative care clinic was 23 days（range：1～492 days）. The mean number of visits to the clinic was 4.7 visits（range：1～29 visits）. A total of 89 patients（80％）needed decision-making support. Of those 89 patients, 33（30％）required support in making a decision about anticancer treatment. Twenty-six（78％）of those 33 patients had just received the diagnosis or were receiving anticancer treatment. <b>Conclusion：</b>The study suggested that decision-making support in early stages is an important role for a palliative care clinic in a designated regional cancer care hospital.
ABSTRACT
<b>Purpose：</b>Chronic cough is one of the symptoms that lead to a reduction in the quality of life insomnia, such as the decline in physical strength. For chronic cough due to metastatic lung tumors, and we experienced an example of after use pregabalin, showed a reduction of symptoms. <b>Case：</b>This case is a 75-year-old man. Abdominoperineal rectal amputation was performed in rectal cancer. Adjuvant chemotherapy has been performed, but multiple lung metastases appeared one year after surgery. Chemotherapy was continued, but lung metastases progressed, it became the policy of anti-cancer treatment ended 4 months after 2 years after surgery. Cough worsened since then, it was referred introduced to palliative care department. Because we thought respiratory tract irritation increased by organic disease is the cause, it starts from 50 mg／day pregabalin, it was increased by 25～50 mg while aware of potential side effects, such as drowsiness during the day. Cough relief at 125 mg／day, night sleep wasalso secure and possible. <b>Conclusion：</b>Pregabalin which is effective in neuropathic pain, there is a possibility that the suppression of hyperexcitability of nerve cells that are its pharmacological action, is also effective in chronic cough, it becomes choice of antitussive different mechanisms of action and opioid there is a possibility that may.
ABSTRACT
<b>OBJECTIVE</b>: To demonstrate the feasibility of webinars, web-based real time interactive seminars, for geographically distant medical students and their tutors.<br><b>METHODS</b>: Six participants from 5 medical schools in Japan were self-selected 3rd to 6th year medical students. A North American medical educator served as their webinar tutor. The students and tutor used home computers to participate in the webinar.<br><b>RESULTS AND CONCLUSIONS</b>: A total of twelve webinars were held, 4 with a tutor and 8 without the tutor. Unstructured tutoring formats included symptom-related differential diagnoses, role-play and patient case discussions. We suggest webinar is a feasible technology to supplement the clinical training of medical students at medical universities.
ABSTRACT
<b>OBJECTIVE</b>: To demonstrate the feasibility of webinars, web-based real time interactive seminars, for geographically distant medical students and their tutors.<br><b>METHODS</b>: Six participants from 5 medical schools in Japan were self-selected 3rd to 6th year medical students. A North American medical educator served as their webinar tutor. The students and tutor used home computers to participate in the webinar.<br><b>RESULTS AND CONCLUSIONS</b>: A total of twelve webinars were held, 4 with a tutor and 8 without the tutor. Unstructured tutoring formats included symptom-related differential diagnoses, role-play and patient case discussions. We suggest webinar is a feasible technology to supplement the clinical training of medical students at medical universities.