A Survey of the Current Status of Fentanyl Sublingual Tablets and Evaluation of Problems Associated with Their Proper Use / 日本プライマリ・ケア連合学会誌

<p><b>Objectives: </b>A survey was conducted to investigate the usability and safety of fentanyl sublingual tablets (FST) and to examine problems associated with their proper use.</p><p><b>Methods: </b>Subjects were 18 cancer inpatients who received FST for breakthrough pain in their pharmacological cancer pain management. Changes in the pain score and the occurrence of adverse effects (nausea, vomiting and somnolence) were compared before and after FST administration.</p><p><b>Results: </b>The pain score before FST administration was 6.4±2.4, and this was significantly improved to 3.4±2.8 at 30 min after administration (p<0.01). Somnolence occurred significantly more often 30 min and 2 h after FST administration than immediately before administration (p<0.05). There were no differences in the occurrence of nausea and vomiting before or after FST administration. Nine patients receiving FST therapy developed xerostomia, but there were no significant changes in the pain score or occurrence of adverse effects while they had xerostomia.</p><p><b>Conclusion: </b>It is essential to observe the oral condition to judge whether FST therapy is indicated, and FST should be administered after providing sufficient oral care. The results indicate the possibility of increased occurrence of somnolence as an adverse effect.</p>

Sex Differences in Relationship between Stress Responses and Lifestyle in Japanese Workers

BACKGROUND: This study examined the relationships between stress responses and lifestyle, including sleeping and eating behaviors, in Japanese workers according to sex. METHODS: Questionnaires about stress responses and lifestyle were completed by 3,017 workers in a financial enterprise (41.5% men, 58.5% women). Data were collected in Japan in August 2011. Participants were classified into stress and nonstress groups. Relationships between stress responses and lifestyle were investigated using logistic regression analysis with stress response as a dependent variable. RESULTS: There were 254 (8.4%) participants in the stress group and 2,763 (91.6%) in the nonstress group. The results showed that sleeping for shorter periods [odds ratio (OR) = 2.97, 95% confidence interval (CI): 1.58-5.60] was associated with stress responses in women, whereas we found no relationship between stress responses and lifestyle among men. However, working overtime was associated with stress responses in men (OR = 2.71, 95% CI: 1.43-5.15). Eating at night was associated with stress responses in the univariate analysis (men: OR = 2.10, 95% CI: 1.16-3.80; women: OR = 1.61, 95% CI: 1.09-2.39). CONCLUSION: This study showed that stress responses were related to lifestyle among women but not among men. Among women, stress responses were related to sleeping for shorter periods, whereas they were related to working long hours among men. In addition, stress responses were related to eating at night in the univariate analysis, although this relationship was not seen in the multivariate analysis, in either sex.

The nursing practice program in the new intern orientation / 医学教育

1) Yokohama City University Hospital has provided a 1-day nursing practice program during the orientation period for first-year interns since 2004. Here we report on the practice performed this year.2) After taking part in the practice, interns described the communication and consultation among the medical team as well as the nurse-patient and nurse-physician relationships. In addition, they recognized the professionalism of nursing.3) To assess the clinical outcome of this practice, we would use the attitude evaluation by head nurses of wards.