高齢がん患者の在宅移行期の文献レビュー

The purpose of this study was to characterize periods of hospital-to-home care transition for elderly cancer patients by extracting definitions of such periods and their characteristics as situations from the literature, and to discuss effective nursing support toward hospital-to-home care transition. Relevant research papers published within the period between ２０１０ and ２０２０ were searched for using Ichushi Web and PubMed. Descriptions related to periods of transition, characteristics of situations, and hindering／promoting factors were extracted without any changes and categorized based on descriptive content similarities. In these papers, a period of hospital-to-home care transition was described as １ week to １ year after discharge. As a situation, it was characterized as “a time when the patient rebuilds his／her life”, and therefore, “a time of instability”. Factors hindering and promoting hospital-to-home care transition were represented by６categories, which suggested the following commonalities between them : ［ physical management］,［patients’／families’ intentions］,［home care systems］,［other family members’ commitments to home care］, ［collaboration systems］, and［nurses’ home care experience］

New findings on the fungal species Tricholoma matsutake from Ukraine, and revision of its taxonomy and biogeography based on multilocus phylogenetic analyses

Publisher Copyright: © 2022 Elsevier B.V.. All rights reserved.Matsutake mushrooms are among the best-known edible wild mushroom taxa worldwide. The representative Tricholoma matsutake is from East Asia and the northern and central regions of Europe. Here, we report the existence of T. matsutake under fir trees in Eastern Europe (i.e., Ukraine), as confirmed by phylogenetic analysis of nine loci on the nuclear and mitochondrial genomes. All specimens from Japan, Bhutan, China, North Korea, South Korea, Sweden, Finland, and Ukraine formed a T. matsutake clade according to the phylogeny of the internal transcribed spacer region. The European population of T. matsutake was clustered based on the β2 tubulin gene, with a moderate bootstrap value. In contrast, based on analyses of three loci, i.e., rpb2, tef1, and the β2 tubulin gene, T. matsutake specimens sampled from Bhutan and China belonged to a clade independent of the other specimens of this species, implying a genetically isolated population. As biologically available type specimens of T. matsutake have not been designated since its description as a new species from Japan in 1925, we established an epitype of this fungus, sampled in a Pinus densiflora forest in Nagano, Japan.Peer reviewe

カンイガタ ジキシキ ショクジ レキホウ シツモンヒョウ（BDHQ） オ モチイタ ガイライ トウニョウビョウ エイヨウ シドウ タイショウシャ チュウシュツホウ ニカンスル ケントウ

【背景】地域に開かれた無床診療所には、管理栄養士はほとんど常勤しておらず、栄養指導が必要な生活習慣 病患者に対する指導でさえも十分に実施できていない現状がある。また、糖尿病栄養指導対象者抽出については、医 師の主観（治療歴、患者背景、患者の性格等）や血液検査値等の客観的指標のみを参考にしており、必ずしも食事調 査結果に基づいた抽出をしている訳ではない。そのため、実際に食習慣が乱れており、糖尿病栄養指導の必要性が高 い患者に対して効率良く栄養指導ができているとは言い難い。 【目的】無床診療所における外来糖尿病患者の治療効果を向上させるため、BDHQ から得られた食事調査結果を活 用した新しい外来糖尿病栄養指導対象者抽出法を確立すること。 【方法】M 医院（大阪府阪南市）に通院している2 型糖尿病患者のうち、研究の趣旨に同意が得られた109 名（男 性77 名、女性32 名、平均年齢64.7±7.4 歳）にBDHQ を実施し、ある1 日の平均的な「栄養素摂取量」を算出し た。次いで当該患者カルテの検査値（HbA1c、クレアチニン等）を記録し、食事調査結果と組み合わせた栄養指導 対象者抽出基準を検討した。 【結果および考察】糖尿病食事療法のうち、栄養基準が大きく変化する糖尿病性腎症第3 期B に該当する患者は、 109 名中25 名であった。このうち、BDHQ から得られたたんぱく質摂取量が1.0g/kg 標準体重/日を上まっている 患者は17 名であり、特にこれらの患者は管理栄養士による詳細な栄養指導を受ける必要性が高いことが考えられる。 BDHQ は集団での妥当性はある程度証明されているが、個人での妥当性は証明されていない。そのため得られた結 果の解釈には慎重な配慮を要する。しかし、少なくとも今回のように、無床診療所において管理栄養士による詳細な 栄養指導を受ける必要性があるか否かを大雑把に判定するような目的には最適であろうと考えられた。Purpose: To improve therapeutic efficacy of ambulatory patients with diabetes in non-bed clinics and to establish a new method of identifying subjects at risk of diabetes related complications using a dietary survey obtained from a brief self administered diet history questionnaire（BDHQ）. Methods: Among patients with type 2 diabetes attending M clinic（Osaka, Japan）, 109 gave informed consent（male 77, female 32, mean age 64.7 ± 7.4 years）. A BDHQ was administered to calculate the average “nutrient intake” per day. The test results in the patients’ medical records（HbA1c, creatinine, etc.） were recorded. The criteria for identifying patients requiring nutritional guidance were also examined in conjunction with the dietary surveys. Results: For 25 of the participants, their nutritional standards put them at risk of third phase B diabetic nephropathy. Of these, the protein intake of 17, as calculated from the BDHQ, was >1.0 g/kg/day. It was considered essential that these patients receive detailed nutritional guidance from registered dietitians. Although the relevance of administering group BDHQ is to some extent proved, the benefit for the individual has not been demonstrated. The interpretation of the results must, therefore, be viewed with caution. However, there are indicators that suggest detailed nutritional guidance by registered dietitians at non bed clinics would be advisable. Keywords: Non bed Clinic, I

若年認知症支援の会「愛都(アート)の会」の活動から作業療法士の役割を考える

若年認知症は老年期の認知症とは異なった特徴を持つが,社会的認知は低く利用可能なサービスが少ないのと同時に,患者は現状のサービス適応が困難である.そのため家族の介護負担は大きく,患者を取り巻く問題は複雑になる.このような中で,我々は,若年認知症支援の会「愛都の会」を発足させ,月に1回の頻度で,ミニ講演会と家族の交流会を開催し,並行してデイサービスを実施して,若年認知症患者の社会参加活動の支援を行っている.サポーターとしてボランティアで参加している作業療法士は,主にデイサービスでの援助を行っている.疾患や病期によって症状や行動が異なる若年認知症患者に対して,個々の状態を評価し,個別に適した活動や対応を選択するためにも,作業療法士が関わる意義は大きい.Early-onset dementia has characteristics that are different to those of late-onset dementia; for such patients, there are few services available at present to help adaptation. Therefore, the care burden falling on the patients family is big, and the problems surrounding the patient become complicated. We started a series of once a month meetings where we help early-onset dementia patients and families by holding a mini-lecture and interactions of families and in parallel carry out a day service that helps the social participation of early-onset dementia patients. Occupational therapists participate by a volunteer and do support by providing day service. The significance that an occupational therapist participates is great, and we evaluate the individual states of early-onset dementia patients finding that symptom and actions are different according to the disorder and stage of the disease, and we choose activities that are suitable for individuals

A novel phthalimide derivative, TC11, has preclinical effects on high-risk myeloma cells and osteoclasts.

Despite the recent advances in the treatment of multiple myeloma (MM), MM patients with high-risk cytogenetic changes such as t(4;14) translocation or deletion of chromosome 17 still have extremely poor prognoses. With the goal of helping these high-risk MM patients, we previously developed a novel phthalimide derivative, TC11. Here we report the further characterization of TC11 including anti-myeloma effects in vitro and in vivo, a pharmacokinetic study in mice, and anti-osteoclastogenic activity. Intraperitoneal injections of TC11 significantly delayed the growth of subcutaneous tumors in human myeloma-bearing SCID mice. Immunohistochemical analyses showed that TC11 induced apoptosis of MM cells in vivo. In the pharmacokinetic analyses, the Cmax was 2.1 μM at 1 h after the injection of TC11, with 1.2 h as the half-life. TC11 significantly inhibited the differentiation and function of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated osteoclasts in mouse osteoclast cultures using M-CSF and RANKL. We also revealed that TC11 induced the apoptosis of myeloma cells accompanied by α-tubulin fragmentation. In addition, TC11 and lenalidomide, another phthalimide derivative, directly bound to nucleophosmin 1 (NPM1), whose role in MM is unknown. Thus, through multiple molecular interactions, TC11 is a potentially effective drug for high-risk MM patients with bone lesions. The present results suggest the possibility of the further development of novel thalidomide derivatives by drug designing