Effect of Social Service Prenatal Care Utilization on Perinatal Outcomes among Women with Socioeconomic Problems in the Tokyo Metropolitan Area

Background. To investigate the effect of social service prenatal care (PNC) utilization on perinatal outcomes among women with socioeconomic problems in the Tokyo metropolitan area. Methods. Retrospective study. The study enrolled all women at our hospital who either attended PNC utilizing social services (attenders) or who did not attend PNC (nonattenders) between January 1, 2007, and December 31, 2010. We compared the maternal characteristics and perinatal outcome of attenders with those of nonattenders. Results. A total of 83 attenders and 45 nonattenders were enrolled. The mean gestational age at the first PNC visit was 31.1 weeks in the attenders. Attenders were found to have a lower incidence of preterm delivery, pregnancy-induced hypertension, emergency cesarean section, low birth weight, and the NICU admission than nonattenders (P < 0.05). Conclusions. The utilization of social service PNC greatly improved perinatal outcomes among women with socioeconomic problems problems in the Tokyo metropolitan area

Association between Public Assistance and Frequent Emergency Department Visits in Urban Areas of Japan: A Case-Control Study

Emergency department（ED）crowding due to frequent visitors increases medical costs and endangers the safety of patients who need prompt treatment. Although some studies have examined the social background of frequent visitors to the ED, there are few comprehensive studies of factors related to frequent ED visits in Japan. The present study examined whether public assistance status, age, and underlying conditions are associated with frequent visits to the ED. Subjects in this study were patients over 20 years of age who visited the ED of General Medicine in Showa University Hospital in Tokyo, Japan, from April 1, 2014, to March 31, 2015（n＝6,182）. Information regarding sex, age, public insurance, hypertension, diabetes mellitus, dyslipidemia, chronic obstructive pulmonary disease, cancer, dysuria, bronchial asthma, and chronic kidney disease was collected using a patient database created from medical and hospital records. Based on a previous study, subjects who visited the ED four or more times were defined as frequent visitors, while those who visited the ED less than four times were considered infrequent visitors. Logistic regression analysis was performed to calculate odds ratios（ORs）and 95％ confidence intervals（CIs）for frequent ED visits. Receipt of public assistance significantly increased the OR for frequent visits（4.26, 95％ CI: 1.90-9.56）, even after adjusting for sex, age, and potential confounding factors（OR: 3.89, 95％ CI: 1.62-9.35）. The current study found a significant association between frequent ED visits and the receipt of public assistance. Emergency physicians and medical practitioners need to share information with outpatient physicians and welfare officers and work together with patients to address their specific medical and social vulnerabilities

Effects of sugar scrub skin care On low birth weight infants in NICU -- Enhanced barrier function --

The skin of low birth weight infants (LBWIs) admitted to the neonatal infant care unit (NICU) has a very thin keratinous layer and is vulnerable to external irritation due to sparse connective tissues, which causes skin disorder easily. A bath using sugar scrub (formulation made of beet sugar and essential oil) has the mildest impact on babies, keeps the skin clean, increases the sebum content, and is expected to enhance the barrier function. The purposes of this study were to clarify the effectiveness of sugar scrub skin care on newborns by comparing a baby soap group and sugar scrub group, and to consider better skin care methods. The subjects were newborns who are born lighter than 2,500 g in NICU & GCU, having a conceptual age of 36 weeks or older. Baby soap was used for control group of six and sugar scrub for experimental group of eight. All were given a bath in the same manner. Data on the sebum content of the chest was collected by a Sebumeter (Sebumeter(R) SM 815; Courage + Khazaka) before and ten minutes after the bath for comparison. The sebum content of the soap group was 3.27+-3.18 (mean+-SD) before the care and 2.30+-2.75 after the care. That of the sugar group was 7.37+-10.77 before the care and 61.60+-15.83 after the care. A significant increase was identified. The difference in sebum content before and after the care was -97+-0.49 for the soap group and 54.23+-21.75 for the sugar group. The sugar group showed a significant increase. The sugar scrub skin care will contribute to an enhanced barrier function by increasing the sebum content

Timing of initial symptom onset during milk and wheat challenges: A retrospective study

Abstract Background Allergic reactions to milk appear sooner than those to hen's eggs, irrespective of the total dose of the oral food challenges (OFCs) and type of matrices. The reported median times for the first symptom occurrence are 20–30 min with milk and 50–60 min with eggs. However, allergic reactions due to wheat have not yet been fully investigated. Methods This study retrospectively collected data from OFC for milk and wheat conducted at Sagamihara National Hospital and Sendai Medical Center from 2009 to 2023. The time from the start of the OFC to the onset of symptoms was compared between children with cow's milk and wheat allergy. Results Twenty‐five and 13 children reacted to single‐dose OFCs with milk products equivalent to 25 mL of raw cow's milk or 15 g of udon noodles, respectively. The median ages of patients with positive challenges were 1.4 and 2.8 years for milk and wheat, respectively, and the median times for the first symptom occurrence were 20 min and 53 min, respectively (p = .006). Conclusion This multicenter study was the first to examine the time of symptom appearance during single‐medium‐dose milk and wheat challenges. Allergic reactions to wheat appear later than those for milk during OFC. For multiadministration OFC for wheat, the dosing interval should be longer than 60 min. Our findings can help improve the safety of OFCs