Japanese primary care physicians' experience in treating their family members: a cross-sectional study.

BACKGROUND: Guidelines worldwide recommend that physicians should not treat their family members. However, studies in the U.S. have shown that approximately 74-83% of physicians have experience of treating family members. Primary care physicians were more likely to have such experiences than other specialists. In Japan, physicians do not have any guidelines regarding treating family members, and little is known about the experiences of primary care physicians. Therefore, we investigated the experience of treating family members or relatives among primary care physicians in Japan. METHODS: This cross-sectional study used an online questionnaire. We recruited 2,000 physicians who were members of the Japan Primary Care Association using random sampling. Data were collected from February 10 to March 10, 2021. We compare the experiences of treating family members between clinic-based doctors and hospital-based doctors using the chi-square test. We performed logistic regression analysis to adjust for gender, age, presence of a doctor in family, and physician's geographic location (rural or not rural). RESULTS: A total of 466 physicians (response rate = 23.3%) completed the survey. Of the sample, 79.8% had experience of treating family members or relatives. In the univariate analysis, being a clinic-based physician was associated with experience in treating family members compared to hospital-based physicians (87.6% vs. 74.9%, p = 0.001). Multivariable analysis showed that being a clinic-based physician (odds ratio 2.30, 95% confidence interval 1.31-4.04) and age of 45-64 years (odds ratio 2.93, 95% confidence interval 1.74-4.93) were significantly related to experience treating family. Gender and geographic location were not statistically significant factors. CONCLUSIONS: A high percentage of Japanese primary care physicians, especially those who worked in clinics, reported experience treating family members or relatives. These findings will serve as basic data for future studies regarding the care of families and relatives of physicians in Japan.

Temporal expression pattern of adhesion genes in human oral mucosal keratinocytes on type IV collagen-coated titanium.

The cell adhesion extracellular matrix (ECM), and the cell adhesive system mediate various adhesion molecules. Cell adhesion regulates proliferation and differentiation. However, the cell adhesive systems between titanium and epithelial cells are still not clearly understood. In this study, we cultured human epithelial cells on type IV collagen-coated titanium (TiCol-4) and non-coated titanium (Ti). We used titanium disks of 30 mm diameter and 1.0 mm thickness. The titanium disks were first abraded using #800, #1200, #2400, and #4000 diamond pads and 0.3 mum alumina, and then washed with acetone, ethanol, and ultra-pure water in an ultrasonic cleaner for 10 min each. Human oral keratinocytes (hOMK) were seeded with 5.0 x 10(4) cells on TiCol-4 and Ti and placed in 6-well culture dishes. The cell adhesion examination was conducted with a Cell Coulter Counter after 1, 3, and 5 h. hOMK were observed using scanning electron microscopy (SEM). Real-time PCR was performed with four primers: gene laminin beta3, integrin beta4, integrin alpha1, and integrin alpha3. The results suggest that TiCol-4 could be used as a means for obtaining better hOMK than Ti. Type IV collagen could provide an excellent substratum for hOMK attachment on titanium surfaces.