長崎県における退院促進支援事業(一学生が経験した事例を通じて)

我が国の精神医療において長期入院および社会的入院が長年の問題点であった。精神科病院における在院日数は減少してきてはいるもののその速度は緩やかである。大阪府において2000年度から「社会的入院解消研究事業」2002年度から「精神障害者地域生活移行支援研究事業」が開始され、2003年度から国の事業として「精神障害者退院促進支援事業」が行われている。長崎県では2003年10月より開始され初年度は13名が参加し2名が退院、1名が支援中に死亡、8名が入院中で支援継続という結果であった。支援内容は外出支援が最も多かった。本研究では継続的に面接を行った。その結果利用者のニーズを細かく十分に把握し支援を進めること、退院だけでなく地域に生活の場を確立することが重要であることがわかった

Observations of airborne Cryptomeria japonica pollen in the summer

ABSTRACTBackground: Airborne Cryptomeria japonica pollen has been detected from July to September, after the main pollen dispersal season (during florescence), in Toyama and Niigata prefectures, Japan.Methods: To identify the source of the pollen, two possible pathways were investigated: (i) secondary pollen dispersal from the ground; and (ii) release from male flowers remaining on the tree crown in C. japonica forests.Results: Secondary pollen dispersal from the ground ceased just after the main pollen dispersal season ended. However, male flowers remained on the crown until the end of September and released significant amounts of pollen, which contained as much allergenic Cry j 1 as normal pollen dispersed during the spring. There is a significant positive correlation between airborne pollen counts in the spring (February-May) and summer (June-September).Conclusions: These results indicate that the main sources of airborne pollen grains during the summer are male flowers remaining on the tree crown after their florescence

The co-existence of NS5A and NS5B resistance-associated substitutions is associated with virologic failure in Hepatitis C Virus genotype 1 patients treated with sofosbuvir and ledipasvir

<div><p>Objective</p><p>The present study aimed to reveal the factors associated with virologic failure in sofosbuvir and ledipasvir (SOF/LDV)-treated patients, and identify baseline NS5A or NS5B resistance-associated substitutions (RASs).</p><p>Methods</p><p>Four hundred ninety-three patients with Hepatitis C Virus (HCV) genotype 1b infection were treated with SOF/LDV; 31 had a history of interferon (IFN)-free treatment with daclatasvir and asunaprevir. The effect of baseline RASs on the response to SOF/LDV therapy was analyzed.</p><p>Results</p><p>Overall, a sustained virologic response at 12 weeks (SVR12) was achieved in 476 patients (96.6%). The SVR12 rates in the patients with IFN-free treatment-naïve and retreatment were 97.6% and 80.6%, respectively. HCV elimination was not achieved in 17 patients, 11 (including 5 with IFN-free retreatment) of whom had virologic failure. Eight patients had coexisting NS5A RASs of Q24, L28 and/or R30, L31, or Y93 and one patient had coexisting NS5A RASs of P32L and A92K. Interestingly, 10 and 8 patients had NS5B A218S and C316N RAS respectively. According to a multivariate analysis, coexisting NS5A RASs, NS5A P32 RAS, NS5B A218 and/or C316 RASs, and γ-glutamyltranspeptidase were associated with virologic failure. In the naïve patients, all patients without NS5B A218 and/or C316 RAS achieved an SVR12. Notably, the SVR12 rates of patients with coexisting NS5A and NS5B RASs were significantly lower (83.3%).</p><p>Conclusions</p><p>Although SOF/LDV therapy resulted in a high SVR12 rate, coexisting NS5A and NS5B RASs were associated with virologic failure. These results might indicate that the coexisting baseline RASs influence the therapeutic effects of SOF/LDV.</p></div

The virologic response rates (intention-to-treat analysis).

<p>The sustained virologic response (SVR) 12 rates of the IFN-free treatment-naïve patients and IFN-free retreatment patients were 97.6% and 80.6% respectively.</p