A Survey of Views on Rx-to-OTC Switches in the Patients Afflicted with Lifestyle-related Diseases such as Hypertension, Diabetes and/or Hyperlipidemia / 社会薬学

<p>To clarify the views and needs on Rx-to-OTC switches in patients afflicted with lifestyle-related diseases such as hypertension, diabetes and/or hyperlipidemia, our survey was conducted with 199 patients at a pharmacy in Tokyo, Japan.Of the 199 patients, 159 people were patients afflicted with lifestyle-related diseases.One hundred and ten patients afflicted with lifestyle-related diseases were seventy-year-old and older, and 149 of the patients have been to a hospital at least once in the past year.Thirty-six point five percent of the patients afflicted with lifestyle-related diseases replied that they wanted to use Rx-to-OTC switches when they had been ill and/or injured.The main reasons that they wanted to use Rx-to-OTC switches were “convenience” and “always the same drugs”.On the other hand, the main reason that they did not want to use Rx-to-OTC switches was “I want to have a detailed examination”.Twenty-three point nine percent of them replied that they wanted to switch their prescription drugs to Rx-to-OTC switches. We believe that the usage of Rx-to-OTC switches after the establishment of a support system to secure safety can be the answer to the issues of the rise in medical care expenditures and doctor shortage.</p>

Assessment of abdominal visceral fat measured by dual bioelectrical impedance analysis in rugby football players / 体力科学

Visceral fat accumulation is a notable risk factor in the incidence of lifestyle-related diseases such as metabolic and circulatory disorders. In this study, we measured visceral fat area (VFA) and subcutaneous fat area (SFA) in rugby football players by using dual bioelectrical impedance analysis, as well as other metabolic and circulatory parameters. A total of 28 male players (15 forwards, 13 backs; mean age±SD: 23±4 years) participated in this study. VFA and SFA were significantly correlated with body weight. Thus, heavier players had higher VFA and SFA as well as higher body weight. In addition, VFA was significantly correlated with various blood parameters such as alanine aminotransferase, gamma-glutamyl transpeptidase, and triglyceride. Six of the 28 players met the criteria for visceral obesity, defined as both body mass index ≥25 kg/m² and VFA ≥100 cm². In some of these players, blood parameters such as high-density lipoprotein cholesterol <40 mg/dL, triglyceride ≥150 mg/dL, or systolic blood pressure ≥130 mmHg indicated elevated risk for metabolic syndrome. These findings suggest that in athletes like heavier rugby football players, abdominal visceral fat accumulation may indicate risk of lifestyle-related diseases.

A mixture of Salacia oblonga extract and IP-PA1 reduces fasting plasma glucose (FPG) and low-density lipoprotein (LDL) cholesterol levels

At present, lifestyle-related diseases are one of the most critical health issues worldwide. It has been reported that lipopolysaccharide derived from a Gram-negative bacteria (IP-PA1) symbiotic with wheat exhibited several advantageous biological effects, such as the reduction of plasma glucose levels in NOD mice and low-density lipoprotein (LDL) levels in WHHL rabbits. In this study, the beneficial effects on plasma glucose and lipids of a tea (SI tea) consisting of IP-PA1 and Salacia (which contains an inhibitor of alpha-glucosidase) were investigated in the KK-Ay/TaJcl type 2 diabetic model mice and in human subjects with premetabolic syndrome in a double-blind, randomized study. SI tea significantly decreased plasma glucose levels in KK-Ay/TaJcl mice. A clinical trial of SI tea was performed with 41 subjects between the ages of 40 and 69, who belonged either to a high plasma glucose group (HG: FPG 100-125 mg/dl) or to a hyperlipidemia group (HL: TG > or = 150 mg/dl, or LDL > or = 120 mg/dl, or HDL < 40 mg/dl). These subjects ingested either Salacia without IP-PA1 (the control) or SI tea. Blood samples were collected at 0, 30, and 60 days after initiating SI tea treatment, and were measured for FPG, HbA1c, TG, LDL, and HDL. These results showed that SI tea reduced FPG and HbA1c more rapidly than the control in the HL group, and also significantly improved LDL and HDL levels in the HG group. Thus, SI tea may be helpful in preventing lifestyle-related diseases.

An Increase in Lifestyle-Related Diseases and Challenges of the Technical Support for Health Care Delivery in Sri Lanka / 国際保健医療

<b>Backgroud</b><br>Sri Lanka is a developing and multiracial country, located in the Indian ocean near the equator, with a population of approximately 20 million. It has a parliamentary democratic system of government and over 80% of hospitals belong to government and medical services are free of charge. Literacy rate of Sri Lanka is higher than the neighbouring countries of the region, and the government's health policies, based on the promotion of Maternal & Child and Geriatric health, are on the way to success. <br>According to the Health Master Plan (HMP) by the Ministry of Healthcare & Nutrition (MOH&N) ,the health problems in this country are classified into three categories based on epidemiological and medical economics:<br>i) Continuing Problems such as dengue fever, ii) Emerging Problems such as HIV/AIDS, and iii) Evolving Problems such as lifestyle-related diseases. <br>It is apprehensive thatthe health conditions and economics of individual Sri Lankan and Nation's economics will be compelled to face the multiple burdens in the near future.<br><b>JICA's Technical Support (JTS)</b><br>JTS on the first prevention against non-communicable diseases (NCDs) has been already startedby JICA after receiving the request by the government of Sri Lanka in order to avoid the catastrophic situations pointed out by HMP. Futhermore, the trend analyses on the data of inpatients suffered 59 types of communicable or NCDs from 1983 to 2003 were performedto propose the tagets and contents of the new JTS. As a result, ffifteen diseases were statistically significant, and nine out of the above15 cases were NCDs.<br>Because lifestyle-related diseases such as ischemic heart disease, cardiovascular diseases occupy four positions out of five leading causes of death in recent past of Sir Lanka, new model system which combines the first prevention and screening of high-risk persons and early treatment system was proposed to MOH&N.<br>The flow of the basic model projiect, composed of two screening steps to detect thespecific persons having high-risks such as obesity, hypertension, high cholesterol, etc., is classified into three groups to receive optimum healthcare sevices at the nearby hospitals.<br>Fortunately, MOH&N made a request for the new JTS based on this proposal to the government of Japan. Consequently, the budget of this project proposal was approved and is now under the practical arrangements by JICA.

The Effect of Spa-aqua Therapy on Lifestyle-related Diseases in Collaboration with Public Spa Facility / 日本温泉気候物理医学会雑誌

<b>Aims</b><br>Yufuin is one of the most famous spa resorts in Japan. However, little attention has been paid to public spa facilities from the viewpoint of their roles in health promotions for the residents. The Yufuin Onsenkan (spa facility) is located in the central portion of the Yufuin spa and has a complete set of spa baths and pools. The aim of this study is to assess the effect of spa-aqua therapy on various lifestyle-related diseases in collaboration with this public spa facility.<br><b>Methods</b><br>We have introduced spa-aqua therapy to patients who had been diagnosed and treated as having certain lifestyle-related diseases (diabetes, hypertension, hyperlipidemia, etc) in our outpatient clinic. One hundred and twenty-four patients consented to participate in the program of aqua exercises (30 minute walk) at least three times a week for more than three months under the supervision of medical doctors, aqua therapists, and public health nurses. These patients were assessed for clinical symptoms and laboratory data at 12 months following the spa-aqua therapy. Subsequently, brachial-ankle pulse wave velocity (baPWV) was measured on 92 healthy volunteers, 21 diabetes patients, and 39 hypertension patients to evaluate the effect of aqua-therapy on arteriosclerosis caused by lifestyle-related diseases.<br><b>Results</b><br>Decreases in clinical symptoms, improvement of laboratory data, and decreases in frequency and dosage of medical prescription were observed in 89 of 124 patients. Specifically, lowered levels of fasting blood sugar and hemoglobin Alc were observed in 20 of 24 diabetic patients and remarkable effects such as lowered blood pressure and decreased dosage of medicine and frequency of medical prescription were observed in 16 out of 20 hypertensive patients. As an index of arteriosclerosis caused by some lifestyle-related diseases, we also measured baPWV on 92 healthy volunteers, 21 diabetes patients, and 39 hypertensive patients before and after introduction of aqua-exercise. From the viewpoint of health insurance, annual medical fees of 35 patients, who were randomly selected from among 124 patients, decreased significantly after receiving aqua therapy combined with medicines. The baPWV values of diabetic and hypertensive patients were significantly higher than those of healthy volunteers before commencing aqua-exercise, and the baPWV values of diabetic and hypertensive patients did not improve significantly after six months of aqua-exercise, suggesting that a longer period of exercise is required.<br><b>Conclusion & Discussion</b><br>In collaboration with a public spa facility used daily by many residents, we succeeded in naturally introducing aqua-spa exercise to the usual habitual behavior of patients with lifestyle-related diseases. This kind of preliminary trial may have future potential not only of promoting health care for local residents but also providing prospects for health care businesses in spa resort areas.