ヨウチエン デノ プレイ セラピー ノ ジッセン ケンキュウ : ヨウジ ノ ソダツ チカラ ト コソダテ シエン トシテノ コウカ

Collaboration was organized between A university and two kindergartens in A city and play therapy was performed with nine children using empty kindergarten classrooms. University teachers with a clinical psychology qualification held discussions with the parents of these children, and kindergarten teachers provided consultation to the parents and exchanged information with them. The effectiveness of play therapy was verified on the basis of a questionnaire conducted before and after play therapy implementation. The results showed that after play therapy, the children became emotionally stable, had fewer behavior problems, and showed an improvement in their social nature. Moreover, seven out of the nine parents perceived that their children had matured. The kindergarten teachers presented the same evaluation from their results. The practice records showed that the children gained confidence and pride by enjoying playing with therapists and being accepted by them, which led to them taking interest in their friends. Their growth potential was activated. In addition, changes in parent−child relationships were observed. Play therapy also supported the parents, and it was considered an effective child raising support measure

Present Status of Blood Pressure Control in a Group of Hypertensive Patients Followed-up in a Cardiovascular Outpatient Clinic

Information on blood pressure control in treated hypertensive patients attending hospital clinics is very scarce in Japan. We investigated the present status of blood pressure control in a large group of 946 consecutive hypertensive patients attending the cardiovascular out-patient clinic of our hospital during a period of a month between 1 April and 30 April 2001. The average blood pressure during the patient\u27s past three visits to the out-patient clinic was 138/83 mm Hg. Patients were divided into 5 age groups. Diastolic blood pressure significantly decreased with age and pulse pressure significantly increased with age, while systolic blood pressure did not differ significantly among the 5 age groups. With regard to blood pressure control, 50% of these patients achieved blood pressure levels less than 140/90 mm Hg, and only 23% achieved blood pressure levels less than 130/85 mm Hg. The achievement rate of blood pressure less than 140/90 mm Hg was the lowest in the group of patients aged less than 50 years among the 5 age groups. The achievement rates of diastolic blood pressure less than 90 mm Hg, 85 mm Hg, and 80 mm Hg were also the lowest in the group of patients aged less than 50 years. The achievement rate of systolic blood pressure less than 140 mm Hg was the lowest in the group of patients aged 80 years or more, although this was not significant. Calcium antagonists were the most prescribed drugs irrespective of age. The prescription rate of calcium antagonists increased with age, while that of β blockers tended to decrease with age. It could be concluded that more efforts should be made to control diastolic blood pressure especially in patients aged less than 50 years as well as to control systolic blood pressure in elderly patients

Cold polypectomy in patients on antithrombotic medication

Background: The cold polypectomy (CP) technique has been increasingly used in recent years. However, there have been few studies about post-polypectomy bleeding (PPB) in patients who underwent CP and who were on antithrombotic drugs. The objective of this study was to determine the safety of CP in patients on antithrombotic medication. Methods: The subjects were patients who underwent CP in our hospital between April 2014 and March 2016. PPB rates were examined in relation to the use of antithrombotic medication. Results: CP was performed to remove 2,466 polyps in 1,003 patients. There were 549 polyps (22.3%) in186 patients in the antithrombotic group and 1,917 polyps (77.7%) in 817 patients in the non-antithrombotic group. PPB occurred in 0.55% (3/549) of patients in the antithrombotic group and in 0.10% (2/1,917) of patients in the non-antithrombotic group, showing no significant difference (p = 0.07). Patients in the antithrombotic group in whom PPB occurred included 1 aspirin user with 1 polyp and 1 aspirin plus clopidogrel user with 2 polyps. No PPB occurred in patients on other antithrombotic agents or receiving heparin bridging. There was no significant difference between PPB rates in patients with small polyps (6-9 mm) in the antithrombotic and non-antithrombotic groups, but there was a significant difference between PPB rates in the 2 groups for patients with diminutive group (1-5 mm). Conclusion: CP is a safe procedure even in patients on antithrombotic medication

Effects of dosing frequency on the clinical efficacy of ampicillin/sulbactam in Japanese elderly patients with pneumonia: A single‐center retrospective observational study

Abstract This study sought to investigate whether dosing frequency (the number of doses per day) affects the antimicrobial efficacy and safety of ampicillin/sulbactam (ABPC/SBT) in Japanese elderly pneumonia patients treated with ABPC/SBT at 6 g/day. This was a retrospective observational study that included hospitalized elderly patients (aged ≥75 years, 10 ml/min ≤CLcr <50 ml/min) who received 3 g every 12 h (BID; n = 61) or 1.5 g every 6 h (QID; n = 45) for the treatment of pneumonia. The primary endpoint was clinical response, assessed by measuring body temperature, white blood cell count, and C‐reactive protein levels. Pharmacokinetic and pharmacodynamic simulations were conducted in silico to rationalize the clinical findings. The clinical response rates (extremely effective and effective) in the BID and QID groups were 36.1% and 55.6%, respectively (p = .0459). QID tended to be more effective in patients with gram‐negative rods detected (p = .0563). According to the simulated minimum plasma ABPC concentrations at steady state for BID and QID were 2.5 and 7.3 μg/ml, respectively (p < .0001). Based on the simulated time above minimum inhibitory concentration (MIC), pharmacological (not clinical) efficacy was predicted to be higher with QID. Both groups had similar safety profiles. The main adverse event in both groups was liver damage. The present retrospective survey demonstrated that ABPC/SBT treatment for elderly patients with pneumonia and renal dysfunction was more effective with QID than with BID. Therefore, the QID regimen is worthy of consideration to improve the clinical outcomes of ABPC/SBT therapy in the present patient population