Evaluation of olfactory impairment using a simple test kit “The Odor Stick Identification test for the Japanese” (OSIT-J) in neurodegenerative diseases

Purpose: Olfactory deficit has been studied in aging, amnestic mild cognitive impairment (aMCI), Alzheimer’s disease (AD). Parkinson\u27s disease (PD), dementia with Lewy bodies (DLB) and idiopathic REM-sleep behavior disorder (iRBD). Our aim was to investigate the usefulness of a simple test kit “The Odor Stick Identification test for the Japanese ”(OSIT-J) in clinical practice.Methods: A total of 240 patients were enrolled in this study, including 44 cognitively normal subjects (NS), 31 patients with aMCI, 70 patients with mild AD (AD-mild), 28 patients with DLB, 31 patients with PD and 36 patients with iRBD. The OSIT-J consists of 12 types of odor sticks. The subjects were asked to select an odor from a list of 4 odors that were rubbed on the medicine wraping paper for each odor stick. The maximum score was 12.Results: The mean odor identification (OI) score decreased in the order of aMCI, iRBD, AD-mild, PD and DLB (NS: aMCI, P<0.05, NS: AD-mild, DLB, PD and iRBD, P<0.001, aMCI: DLB, P<0.001, aMCI: PD, P<0.01 (Kruskal-Wallis, Dunn’s test). The sensitivity and specificity in differentiating each disease from NS at a cutoff value of 8 was 96.8% and 79.5%, respectively, in PD, and 96.4% and 79.5% in DLB. An ageing effect was observed in NSs ( r=-0.453 (p<0.01)).Conclusions: Olfactory deficit is a non-specific phenomenon. However, it is important to be aware of the underlying diseases or future development of diseases. The OSIT-J, which is a simple test, is useful for detecting OI abnormalities in daily clinical practice

Effectiveness of simulation learning program for mastering public health nursing skills to enhance strength of community: A quasi-experimental design

Purpose: The purpose of this study is to develop a simulation learning program for mastering public health nursing skills to enhance strength of community, and to verify its effectiveness. Methods: The program is one-day session to master the skills from three exercises. This study adopts a quasi-experimental design. We selected unbiased 34 participants in intervention group and 30 participants in control group, and conducted self-administered questionnaire surveys at three points in time: pre, post 1 and post 2. Three tools were used to measure the required outcome. For the outcome evaluation, we calculated the changes in the mean value of each tool between pre and post 1 and between pre and post 2, and compared them between the two groups. Results: The change of intervention group in the total score at the post 1 stage from the pre stage was significantly higher than control group regarding each of the scales (P < .05). Conclusions: The program was found to be effective in upgrading the skills of less-experienced public health nurses to enhance strength of community

Early and long?term outcomes of endoscopic submucosal dissection for early gastric cancer in a large patient series

Endoscopic submucosal dissection (ESD) enables the curative resection of early gastric cancer (EGC); however, little information is available on the long-term outcomes of ESD. This study was conducted to clarify the clinical outcomes of a large number of patients with EGC who underwent ESD. The early outcomes were assessed in 1,209 patients and the long-term outcomes were assessed in 300 patients at a follow-up >5 years after the ESD procedure. The overall survival rates were compared between indication and expanded-indication groups, and between the patients who did or did not undergo additional surgery in an out-of-indication group. Overall survival rates were also compared among different age groups. In total, 617 lesions were classed as the indication group, 507 as the expanded-indication group and 208 as the out-of-indication group. Curative resection rates were 96.6% and 91.5% in the indication and expanded-indication groups, respectively. In terms of the long-term outcomes, 20 of the 146 patients in the indication group, 15 of the 105 patients in the expanded-indication group and one of the 23 patients who underwent additional surgery in the out-of-indication group succumbed due to causes other than gastric cancer. Among the 26 patients who did not undergo additional surgery in the out-of-indication group, 10 mortalities occurred, including one due to gastric cancer. The five-year survival rates were not significantly different between the indication and expanded-indication groups. In the out-of-indication group, the five-year survival rate for the patients who did not undergo additional surgery (65.0%) was significantly lower than that for those who did undergo additional surgery (100%) (P80 years (67.1%) was significantly lower than that of the younger patients (<60 years, 91.6%; sixties, 93.0%; seventies, 84.5%) (P<0.0001). In conclusion, although expanded-indication of ESD for EGC is appropriate, comorbidities require consideration in elderly patients

Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2010: General view of the pathogens\u27 antibacterial susceptibility

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from patients in Japan, was conducted by Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases and Japanese Society for Clinical Microbiology in 2010.The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period from January and April 2010 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical and Laboratory Standard Institutes using maximum 45 antibacterial agents.Susceptibility testing was evaluable with 954 strains (206 Staphylococcus aureus, 189 Streptococcus pneumoniae, 4 Streptococcus pyogenes, 182 Haemophilus influenzae, 74 Moraxella catarrhalis, 139 Klebsiella pneumoniae and 160 Pseudomonas aeruginosa). Ratio of methicillin-resistant S.aureus was as high as 50.5%, and those of penicillin-intermediate and -resistant S.pneumoniae were 1.1% and 0.0%, respectively. Among H.influenzae, 17.6% of them were found to be β-lactamase-non-producing ampicillin (ABPC)-intermediately resistant, 33.5% to be β-lactamase-non-producing ABPC-resistant and 11.0% to be β-lactamase-producing ABPC-resistant strains. Extended spectrum β-lactamase-producing K.pneumoniae and multi-drug resistant P.aeruginosa with metallo β-lactamase were 2.9% and 0.6%, respectively.Continuous national surveillance of antimicrobial susceptibility of respiratory pathogens is crucial in order to monitor changing patterns of susceptibility and to be able to update treatment recommendations on a regular basis

TRPM2 Contributes to Inflammatory and Neuropathic Pain through the Aggravation of Pronociceptive Inflammatory Responses in Mice.

慢性痛の原因となる神経炎症応答の増悪機構を解明－新しい鎮痛薬開発の可能性－. 京都大学プレスリリース. 2012-03-15.Accumulating evidence suggests that neuroimmune interactions contribute to pathological pain. Transient receptor potential melastatin 2 (TRPM2) is a nonselective Ca(2+)-permeable cation channel that acts as a sensor for reactive oxygen species. TRPM2 is expressed abundantly in immune cells and is important in inflammatory processes. The results of the present study show that TRPM2 plays a crucial role in inflammatory and neuropathic pain. While wild-type and TRPM2 knock-out mice showed no difference in their basal sensitivity to mechanical and thermal stimulation, nocifensive behaviors in the formalin test were reduced in TRPM2 knock-out mice. In carrageenan-induced inflammatory pain and sciatic nerve injury-induced neuropathic pain models, mechanical allodynia and thermal hyperalgesia were attenuated in TRPM2 knock-out mice. Carrageenan-induced inflammation and sciatic nerve injury increased the expression of TRPM2 mRNA in the inflamed paw and around the injured sciatic nerve, respectively. TRPM2 deficiency diminished the infiltration of neutrophils and the production of chemokine (C-X-C motif) ligand-2 (CXCL2), a major chemokine that recruits neutrophils, but did not alter the recruitment of F4/80-positive macrophages in the inflamed paw or around the injured sciatic nerve. Microglial activation after nerve injury was suppressed in the spinal cord of TRPM2 knock-out mice. Furthermore, CXCL2 production and inducible nitric oxide synthase induction were diminished in cultured macrophages and microglia derived from TRPM2 knock-out mice. Together, these results suggest that TRPM2 expressed in macrophages and microglia aggravates peripheral and spinal pronociceptive inflammatory responses and contributes to the pathogenesis of inflammatory and neuropathic pain

State change of the Hikikomori persons and their family members by counseling

静岡県ひきこもり支援センターにおいて面接相談を行ったケースの状態変化ついて、静岡式ひきこもり評定尺度を用いて分析を行った。親が相談を行うことによって、親が当初抱いていた不安や焦りが和らぎ、本人との間の緊張が軽減し、本人にも良い変化が生じていた。本人のひきこもり状態の改善のためには、本人が安心できる環境を家族が整えることが重要であり、そのために支援者は家族が安心感を持てるように支援する必要がある。また、家族間のコミュニケーションが改善することによって、本人に大きな変化が 生じることが示された。この結果はひきこもり支援プログラム「CRAFT」の目指す方向性と一致するものであった。短期間で目に見える変化が生じにくいひきこもり支援においては、親や当事者の小さな変化や改善を可視化することで、長期にわたる支援の動機付けを維持していくことが有効であると 考えられる