Enhancing the Professional Functions of Pharmacists: A Focus on Increasing Anti-doping Awareness among Physical Education University Students / 社会薬学

Introduction: Recently, doping among athletes has been on the rise, and pharmacists have an important role in both the promotion of anti-doping (AD) and in providing accurate information and effective support. In this study, we examined various fact-finding surveys that targeted physical education university (PEU) students, and we focused on their use of pharmacies/drugstores, their involvement with pharmacists, and knowledge about AD. We also examined the necessary AD-related professional competencies of pharmacists. Method: Questionnaire surveys were prepared, and the responses of 1,249 students were analyzed. Results : From a survey on what students buy at pharmacies/drug stores it showed that medicines for flu common colds sell the most. Most of the students did not receive any drug consultations at pharmacies/drug stores before purchasing, because they preferred to make their own decisions about drug use. Also, many students were wary of doping with supplements. Although the students who participated in international sports competitions and events possessed a wealth of doping-related knowledge and awareness, PEU students lacked them. Discussion : We determined that it was necessary to gather relevant patient information and explore methods so that intentions could be discussed when purchasing medications from pharmacies/drug stores. We also recognized the need for early doping education programs in light of the inadequate AD-related knowledge and awareness among university student-athletes. Therefore, all pharmacists should strive to acquire a wide range of knowledge to support athletes in this effort. Furthermore, we believe that expanding the professional functions of pharmacists would increase the awareness of AD among athletes.

Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)

ObjectiveTo identify common features of cases with novel coronavirus disease (COVID-19) so as to better understand what factors promote secondary transmission including superspreading events. MethodsA total of 110 cases were examined among eleven clusters and sporadic cases, and investigated who acquired infection from whom. The clusters included four in Tokyo and one each in Aichi, Fukuoka, Hokkaido, Ishikawa, Kanagawa and Wakayama prefectures. The number of secondary cases generated by each primary case was calculated using contact tracing data. ResultsOf the 110 cases examined, 27 (24.6%) were primary cases who generated secondary cases. The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment (95% confidence interval [CI]: 6.0, 57.9). ConclusionsIt is plausible that closed environments contribute to secondary transmission of COVID-19 and promote superspreading events. Our findings are also consistent with the declining incidence of COVID-19 cases in China, as gathering in closed environments was prohibited in the wake of the rapid spread of the disease.

Assessing the impact of reduced travel on exportation dynamics of novel coronavirus infection (COVID-19)

The impact of the drastic reduction in travel volume within mainland China in January and February 2020 was quantified with respect to reports of novel coronavirus (COVID-19) infections outside China. Data on confirmed cases diagnosed outside China were analyzed using statistical models to estimate the impact of travel reduction on three epidemiological outcome measures: (i) the number of exported cases, (ii) the probability of a major epidemic, and (iii) the time delay to a major epidemic. From 28 January to 7 February 2020, we estimated that 226 exported cases (95% confidence interval: 86, 449) were prevented, corresponding to a 70.4% reduction in incidence compared to the counterfactual scenario. The reduced probability of a major epidemic ranged from 7% to 20% in Japan, which resulted in a median time delay to a major epidemic of two days. Depending on the scenario, the estimated delay may be less than one day. As the delay is small, the decision to control travel volume through restrictions on freedom of movement should be balanced between the resulting estimated epidemiological impact and predicted economic fallout.

Estimation of the asymptomatic ratio of novel coronavirus (2019-nCoV) infections among passengers on evacuation flights

A total of 565 Japanese citizens were evacuated from Wuhan, China to Japan. All passengers were screened for symptoms and also undertook reverse transcription polymerase chain reaction testing, identifying 5 asymptomatic and 7 symptomatic passengers testing positive for 2019-nCoV. We show that the screening result is suggestive of the asymptomatic ratio at 41.6%.

Real time estimation of the risk of death from novel coronavirus (2019-nCoV) infection: Inference using exported cases

The exported cases of 2019 novel coronavirus (COVID-19) infection that were confirmed outside of China provide an opportunity to estimate the cumulative incidence and confirmed case fatality risk (cCFR) in mainland China. Knowledge of the cCFR is critical to characterize the severity and understand the pandemic potential of COVID-19 in the early stage of the epidemic. Using the exponential growth rate of the incidence, the present study statistically estimated the cCFR and the basic reproduction number--the average number of secondary cases generated by a single primary case in a naive population. We modeled epidemic growth either from a single index case with illness onset on 8 December, 2019 (Scenario 1), or using the growth rate fitted along with the other parameters (Scenario 2) based on data from 20 exported cases reported by 24 January, 2020. The cumulative incidence in China by 24 January was estimated at 6924 cases (95% CI: 4885, 9211) and 19,289 cases (95% CI: 10,901, 30,158), respectively. The latest estimated values of the cCFR were 5.3% (95% CI: 3.5%, 7.5%) for Scenario 1 and 8.4% (95% CI: 5.3%, 12.3%) for Scenario 2. The basic reproduction number was estimated to be 2.1 (95% CI: 2.0, 2.2) and 3.2 (95% CI: 2.7, 3.7) for Scenarios 1 and 2, respectively. Based on these results, we argued that the current COVID-19 epidemic has a substantial potential for causing a pandemic. The proposed approach provides insights in early risk assessment using publicly available data.

Epidemiological characteristics of novel coronavirus infection: A statistical analysis of publicly available case data

The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2-14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3-4 days without truncation and at 5-9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.

Loiasis in a Japanese traveler returning from Central Africa

We encountered a probable case ofloiasis in a returned traveler from Central Africa. A 52-year-old Japanese womanpresented to our hospital complaining of discomfort in her eyes and skin. She reportedhaving frequently visited Central Africa over many years and having been extensivelyexposed to the rainforest climate and ecosystem. Although no microfilariae werefound in her blood, there was an elevated level of IgG antibodies against thecrude antigens of<i> Brugia pahangi</i>,which have cross-reactivity with <i>Loa loa</i>.She was treated with albendazole for 21 days, after which the antigen-specificIgG level decreased and no relapse occurred.

Loiasis in a Japanese Traveler Returning from Central Africa

We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of <i>Brugia pahangi</i>, which have cross-reactivity with <i>Loa loa</i>. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

Perioperative Management to Prevent Postoperative Pulmonary Embolism in General Surgical Patients / 日本農村医学会雑誌

Recently, the incidence of pulmonary embolism (PE) after surgery began to increase in Japan and to prevent PE has become essentially important. During the period between July 2003 and August 2004, we placed 203 general surgical patients under our perioperative management using intermittent pneumatic compression (IPC) and compression stockings (CS). We evaluated the effect of our management on the prevention of postoperative PE in those patients. The incidence of PE, prognosis, complications, patient's complaints, cost-benefit were examined. No fatal PE occurred. One patient with low SpO2 had a chest pain and dyspnea but pulmonary scintigrams revealed no PE. Two other patients had contact dermatitis by CS and another patient using an epidural catheter suffered temporary paraplegia after heparin injection. The government has approved a fee for PE prophylaxis since April 2004. Our management using IPC and CS for PE prophylaxis after surgery proved to be an effective in reducing the risk of PE. However, we must take the atmost care in injecting heparin into patients with epidural catheters.