著者
豊田 紗和子 吉村 祐奈 矢野 玲子 青柳 裕 大津 史子 後藤 伸之
出版者
一般社団法人 日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.21, no.2, pp.70-78, 2019-08-31 (Released:2019-10-10)
参考文献数
31

Objective: To clarify the background difference between drug-induced photosensitivity and ultraviolet-visible absorption spectrum or structure and to construct useful information for prevention and prediction of drug-induced photosensitivity. Methods: We investigated whether, for 457 drugs for which the ultraviolet-visible absorption spectrum is listed in the Japanese Pharmacopoeia, there were absorption maxima in the UVA (320 nm or more and less than 400 nm), UVB (280 nm or more and less than 320 nm), or UVA and UVB (280 nm or more and less than 400 nm). Structure was investigated for the existence of “conjugated”, carbonyl, sulfone, nitro and fluorine. The case drug group was taken to be those drugs for which photosensitivity was listed as a side effect on the medical drug package insert. Using statistical software, SPSS statistics ® 24 (IBM), we performed univariate logistic regression analysis, and multivariate logistic regression analysis with a stepwise increment method (likelihood ratio) combining items with p<0.2, and calculated the odds ratio (hereinafter: aOR). The significance level was taken as 0.05.Results: There were 85 drugs in the case drug group, and 372 drugs in the control drug group. As a result of multiple logistic regression analysis, in Model 1, we placed sulfone (aOR: 4.55, 95% C.I.: 2.22-9.35), fluorine (aOR: 3.66, 95% C.I.: 1.82-7.39) and nitro (aOR: 4.46, 95 % C.I.: 1.73-11.48) in this order. In Model 2, we placed sulfone (aOR: 4, 40, 95% C.I.: 2.12-9.15), fluorine (aOR: 3.81, 95% C.I.: 1.87-7.76), UVA (aOR: 2.40, 95% C.I.: 1.37-4.18) and nitro (aOR: 3.61, 95% C.I.: 1.39-9.40) in this order.Conclusion: When a drug is developed, its ultraviolet-visible absorption spectra and structure become clear, and from this information,measures can be taken which bear the potential risk of photosensitivity in mind.
著者
丹羽 浩子 田辺 公一 矢野 玲子 後藤 伸之 大津 史子
出版者
一般社団法人 日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.20, no.3, pp.145-155, 2018-11-30 (Released:2018-12-08)
参考文献数
26

Objective:In this study,we explored adverse reactions and patient background and performed a case/non-case study on a database of adverse reaction case reports in order aid the prevention of non-prescription drug abuse.Study Design:We conducted a case/non-case study on a database of adverse reaction case reports.Methods:We studied case reports of adverse reactions and addiction in Japan and extracted adverse reaction cases associated with taking antipyretic analgesics,antitussive drugs,antitussive expectorant drugs,hypnotic and sedative drugs,anti-anxiety drugs,and purgative drugs. We divided the extracted cases into an abuse case group (adverse reactions associated with non-prescription drug abuse,and divided its intended purpose or the purpose of abuse at the initial dose)and non-case group(other adverse reactions). We performed univariate logistic regression analysis on each item of investigation in the abuse case group and non-case group and calculated the odds ratio,p-value,and 95%confidence interval.Results:There were many abuse case reports of women 20-40 years old in the antipyretic analgesics abuse case group and many of them had liver/biliary lesions and chronic urological impairment. The most common reason reported for taking the initial dose of each drug was for its intended purpose.Discussion:It is important for pharmacists at community pharmacies and drugstores to be able to recognize the characteristics of patients who might be at risk of abuse and the adverse reactions and patient backgrounds elucidated in this study could be helpful in identifying them.
著者
小池 麻由 大津 史子 榊原 仁作 後藤 伸之
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.14, no.4, pp.134-143, 2013-02-28 (Released:2013-03-06)
参考文献数
20
被引用文献数
3

Objective: Recently, use of health foods and supplements, as well as the amount of information available about them, has been steadily increasing.  Therefore, a noticeable increase in adverse drug reactions caused by health foods and supplements has also been seen.  The purpose of this study was to clarify the current status and backgrounds of patients with health food- or supplement-related adverse health effects.Methods: We selected the cases of health food- or supplement-related adverse health effects from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database, which contains over 57,000 case reports of adverse drug reactions.  We investigated the background, suspected products and adverse events in each case and conducted univariate logistic regression analysis to determine significance.Results: We obtained a total of 327 cases consisting of 103 causative products.  Women comprised 66% of study subjects and had a significant association with dietary supplements.  Patients with a history of liver disease had a significant association with liver damage caused by “Ukon,” a drink made from turmeric root and sold as an anti-hangover remedy in Japan.Conclusion: The causative products had several unique features.  This information should be utilized to prevent health food- and supplement-related adverse health effects in the future.
著者
永光 加奈 田辺 公一 後藤 伸之 大津 史子
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.44, no.7, pp.370-379, 2018-07-10 (Released:2019-07-10)
参考文献数
7

We investigated the current situation of pharmacists' recognition of and countermeasures they take against adverse drug reactions (ADRs) in order to elucidate related factors. We administered a web-based questionnaire to pharmacists who work at community pharmacies. The factors included in the questionnaire were basic information, recognition of and countermeasures against ADRs (the frequency of ADR recognition, investigation medium, the recognition of and countermeasures against ADRs and reasons for those). There were 29 questions about ADR education in total. In this study, we focused on the frequency of ADR recognition and countermeasures taken against ADRs, and examined their current status and related factors. As a result, after performing multivariable logistic regression analysis, we found that the group of pharmacists who made prescription inquiries about patients had an association with the investigation medium they used and are likely to investigate actively. Our results suggest the possibility that many pharmacists differed in their knowledge about the onset and recognition of ADRs. Moreover, our results found situations where prescription inquiries were actively made, but ADRs were not adequately reported. In conclusion, pharmacists who make prescription inquiries are likely to investigate and actively use information media, and this suggests the necessity of selecting the appropriate information medium and critically examining information. However, since those who answered our survey were biased towards the young, it is necessary to consider the possibility that this influenced the results.
著者
掛谷 雅之 大津 史子 矢野 玲子 榊原 仁作 後藤 伸之
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.16, no.2, pp.70-80, 2014 (Released:2014-09-06)
参考文献数
23

Objective: The present study investigated risk factors and subjective symptoms associated with drug-induced thrombocytopenia.Methods: We selected 361 patients with drug-induced thrombocytopenia from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65,000 case reports of adverse drug reactions and assigned these patients to a case group.  We also randomly selected 794 cases of adverse drug reactions not associated with thrombocytopenia as a control group.Results: Data were compared between the case and control groups, and results were analyzed using logistic regression analysis.  We identified type of infection (non-viral) and renal failure as risk factors for drug-induced thrombocytopenia.  In addition, administration of carbamazepine, methotrexate, interferon alpha, ticlopidine or valproic acid significantly increased the risk of drug-induced thrombocytopenia.  Significant associations were also found between drug-induced thrombocytopenia and purpura, fever, and mucosal bleeding.Conclusion: These findings provide helpful information for early detection and prevention of thrombocytopenia as a serious adverse drug reaction.
著者
後藤 伸之 月岡 理絵 八田 壽夫 政田 幹夫 北澤 式文
出版者
日本臨床薬理学会
雑誌
臨床薬理 (ISSN:03881601)
巻号頁・発行日
vol.27, no.2, pp.465-468, 1996-06-30 (Released:2010-06-28)
参考文献数
9

We performed a pharmacoepidemiological study on triazolam dependence with typical doses in out-patients of Fukui Medical School Hospital. We investigated the prescriptions (duration of treatment and total dose prescribed) for patients administered triazolam.The patients were classified according to the prescription pattern of this drug, Group 1: patients who had been prescribed triazolam daily, Group 2: those who had been allowed to take triazolam when they cannot sleep.Approximately 40% of all the patients had been prescribed triazolam for 8 months or longer, and were judged to be normal dose dependence. The prevalence of this dependence was apparently higher in group 1 than in group 2.
著者
五十嵐 敏明 今野 彩 塚本 仁 矢野 良一 渡辺 享平 中村 敏明 政田 幹夫 後藤 伸之
出版者
一般社団法人 日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.20, no.2, pp.66-71, 2018-08-31 (Released:2018-09-12)
参考文献数
10

Objective: We have developed an automatic vigilance system (AVS) that automatically reports adverse drug reactions (ADR) based on laboratory finding abnormalities and symptom keywords in electronic medical records. In this study, we aimed to evaluate the impact of detecting ADR using AVS on medical treatment. Methods: In AVS, drugs and their ADR signals, which would be detected and reported by AVS to pharmacists, were defined. Pharmacists evaluated the severity of these signals to identify whether these signals should be discussed with the doctor, continued to be followed up, or ignored. We investigated detection of ADR at University of Fukui Hospital between April 2016 and March 2017 along with whether prescriptions were modified because of ADR and the contribution of AVS. Assuming that ADR had worsened without appropriate treatment, medical expenses needed for treating severe ADR were calculated. Results: In total, 325 signals were defined for 146 drugs. There were 9,103 ADR signals confirmed by pharmacists for 8,531 subjects. Of these, 12 and 164 signals were discussed with the doctor and continuously observed, respectively. The pharmacist's suggestions based on AVS led to prescription modifications in 10 cases, corresponding to a reduction of 2.56 million yen in medical expenses in the event that these cases become severe. Conclusion: AVS assisted prescription revisions because of ADR and is thought to contribute to the prevention of worsening of ADR and reduction of medical expenses.
著者
飯久保 尚 青柳 吉博 浅田 和広 後藤 伸之 近澤 洋平 多田 公揚 柳瀬 秀明 若林 進
出版者
Japanese Society of Drug Informatics
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.19, no.4, pp.149-157, 2018 (Released:2018-03-21)
参考文献数
7

Objectives: Many pharmaceutical companies provide information on prescription drugs on their websites.  These websites are popular search tools for drug information for many reasons, including the availability of information at all times.  However, there are various sources of confusion for users, such as the website content differing between companies.  Therefore, to improve the usability of websites created by pharmaceutical companies, we investigated the expectations and perceptions of website users of current websites and presented our results to website users and developers.Design: A questionnaire survey.Methods: Website users were surveyed using a questionnaire developed based on data obtained from a preliminary survey of drug information pharmacists registered at the Japanese Society of Drug Informatics.  Then, using data from the user survey, we conducted a survey of website developers for pharmaceutical companies.Results: When asked what makes the websites of pharmaceutical companies excellent, 55.7% of users responded “a website filled with information.”  When asked how the website of pharmaceutical companies should be structured, the most common answer was “searchability and visibility” in responses in free-description format (25.3%) and was “inter-company consistency regarding types of drug information available as well as the process required for obtaining drug information” for responses in multiple-choice format (88.6%).  When asked whether users were unable to obtain drug information when needed because user registration was required, 87.3% of the users replied affirmatively, although 47.1% responded that some content should require user registration.  Of website developers, 46.9% collected and analyzed information about users’ website use.  They also hoped to identify the users’ needs.Discussion: The findings suggest that the usability of websites could be improved by providing opportunities for website users and developers to exchange opinions and by standardizing the content of pharmaceutical company websites, including what information should require user registration.
著者
鈴木 亮平 大津 史子 後藤 伸之
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
vol.135, no.7, pp.895-916, 2015 (Released:2015-07-01)
参考文献数
10

The purpose of this study was to develop and validate estimate equations for preventing adverse drug reactions (ADRs). We conducted five case-control studies to identify individual risk factors and subjective symptoms associated with the following five ADRs: drug-induced ischemic heart disease; renal damage; muscle disorder; interstitial pneumonia; and leucopenia. We performed logistic regression analysis and obtained eight regression equations for each ADR. We converted these to ADR estimate equations for predicting the likelihood of ADRs. We randomly selected 50 cases with non-individual ADRs from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65000 case reports of ADRs, and assigned these cases to a validation case group. We then calculated the predictive probability for 50 cases using the eight estimate equations for each ADR. The highest probability for each ADR was set as the probability of each ADR. If the probability was over 50%, the case was interpreted as ADR-positive. We calculated and evaluated the sensitivity, specificity, and positive likelihood ratio of this system. Sensitivity of the estimate equations for muscle disorder and interstitial pneumonia were ≥90%. Specificity and positive likelihood ratios of estimate equations for renal damage, interstitial pneumonia and leucopenia were ≥80% and ≥5, respectively. Our estimate equations thus showed high validity, and are therefore helpful for the prevention or early detection of ADRs.
著者
森 千与 酒井 隆全 矢野 玲子 田辺 公一 後藤 伸之 大津 史子
出版者
一般社団法人日本医薬品情報学会
雑誌
医薬品情報学 (ISSN:13451464)
巻号頁・発行日
vol.18, no.4, pp.261-269, 2017-02-28 (Released:2017-03-17)
参考文献数
24

Purpose: The purpose of this study is to elucidate the characteristics of adverse events in pregnant women, the offending drugs, and patient backgrounds from reports of adverse events.  We performed a case series study.Methods: We used CARPIS, a database of adverse events and toxication reported in Japan spanning from 1987 to 2014 and created by the Drug Information Center, Meijo University.  We extracted cases of adverse events in pregnant women, their fetuses, and newborns and investigated the age, primary disease, and history of allergies of the women and the intended use of/offending drugs, therapeutic category, and names for adverse events.Result: We collected 434 cases of adverse events in pregnant women, and 251 pediatric cases with adverse events.  The most frequent offending drug in both groups was ritodrine hydrochloride.  The most frequent adverse event in pregnant women was pulmonary oedema due to the administration of ritodrine hydrochloride.  The most frequently reported adverse events in pediatric cases were transient hypothyroidism and withdrawal symptoms in newborns and birth abnormalities in fetuses and newborns, all of which were caused by drugs given for the underlying diseases of their mothers.Discussion: We elucidated serious adverse events in pregnant women caused by the administration of ritodrine hydrochloride.  Frequent factors for adverse events were the onset of physiological factors in pregnant women and complicated factors of the mechanism of action of ritodrine hydrochloride.  We need to monitor both mothers and fetuses during the drug administration.  It is suggested that adverse events in pediatric cases are associated with drugs given for underlying diseases in mothers.  Thus, it is necessary to give appropriate information and communicate the risks of taking these drugs before pregnancy.  We believe the results could be helpful in the early detection of adverse events in the future.
著者
後藤 伸也
出版者
一般社団法人 表面技術協会
雑誌
表面技術 (ISSN:09151869)
巻号頁・発行日
vol.56, no.8, pp.447, 2005 (Released:2006-03-29)
参考文献数
6
被引用文献数
2
著者
田中 博春 井上 君夫 足立 幸穂 佐々木 華織 菅野 洋光 大原 源二 中園 江 吉川 実 後藤 伸寿
出版者
公益社団法人 日本地理学会
雑誌
日本地理学会発表要旨集
巻号頁・発行日
vol.2010, pp.83, 2010

<B>I. はじめに</B><BR> 地球温暖化による気候変動は、農作物の栽培適地移動や栽培不適地の拡大、夏季の高温による人々の健康被害等、多くの好ましくない事例が発生することが懸念される。特に都市化に伴うヒートアイランドの拡大は、高温による人的被害をさらに助長する可能性があり、将来の気候変化を見据えた都市・農地の開発計画が必要である。そこで、農研機構が開発した「気候緩和機能評価モデル」に、気候シナリオを再現できる機能を組み込み、将来気候下で農地・緑地等の気候緩和機能を評価できるようにした。<BR><BR><B>II. モデル概要</B><BR> 「気候緩和機能評価モデル」は農研機構中央農業総合研究センターが2004~2006年に開発した領域気候モデルである(井上ほか, 2009)。コアモデルとしてTERC-RAMS(筑波大学陸域環境センター領域大気モデリングシステム)を用いており、サブモデルとして植生群落サブモデルと単層の都市キャノピーモデルを追加している。Windows XP搭載のPCにて日本全国を対象としたシミュレーションが可能であり、計算条件の設定から結果表示まで、すべてグラフィカルユーザーインターフェースによる操作が可能である。計算可能な期間は1982~2004年。計算可能な水平解像度は最大250m。1976,1987,1991,1997年の全国の土地利用を整備しており、それを元にユーザー側で自由に土地利用の変更が可能である。モデル内の都市を農地に変更することで、現在から将来までの農地の持つ気候緩和効果の理解が容易にできる。 2009年は上記モデルの「気候シナリオ版」を作成し、IPCCにより策定されたA1B気候シナリオに基づいた気候値の予測データ(MIROC)を組み込み、気温や降水量の変化を1kmメッシュで再現できるようにした。計算可能な期間は、1982~2004年の現在気候、および現在気候と同条件下の2030年代と2070年代の将来気候である。<BR><BR><B>III. モデル適用事例</B><BR> 現在気候の計算例として、仙台平野を中心とした領域における2004年7月20日の日平均気温分布を示す(図1(a))。この日は東京で史上最高気温(39.5℃)を記録するなど現在気候下で猛暑の事例である。モデル計算により、日平均気温28℃以上の高温域が仙台平野の広い範囲に分布していることが把握できる。<BR> 同じ期間における2030年代の気温を計算すると、計算領域全体で約1.5℃の気温上昇が認められる(図1(b))。仙台市を中心とする平野部が最も高温であり、海岸部では海風の進入によると思われる低温域が形成されている。さらに、同じ期間における2070年代の気温を計算すると、平野部を中心として32度以上の高温域が広範囲に形成されている(図1(c))。<BR> 2004年と2030年代の気温差を計算すると、領域北部で昇温が大きく、海岸部で相対的に小さい特徴的な分布が把握できる(図2)。これに関しては、海岸部では内陸の昇温により海風の進入が強まり、日中の昇温を現在よりも抑制することが考えられる等、将来の気候分布に力学的な解釈が適用可能である。<BR><BR><B>IV. モデルの利用方法</B><BR> 本気候緩和機能評価モデルの利用にあたっては、下記宛てにご連絡下さい。利用申請を頂いた後、500GB以上のハードディスクを郵送して頂くことで、プログラム・データを無償配布している。本気候緩和機能評価モデルは、日本国内の身近な地域の温暖化を予測するツールとして最適であり、大学や研究機関、中学校・高等学校にての教育や、自治体等で利用可能である。<BR><BR><B>連絡先:</B><BR>独立行政法人 農業・食品産業技術総合研究機構<BR>東北農業研究センター やませ気象変動研究チーム<BR>田中 博春 宛<BR><BR><B>文献:</B><BR>井上君夫・木村富士男・日下博幸・吉川実・後藤伸寿・菅野洋光・佐々木華織・大原源二・中園江 2009. 気候緩和評価モデルの開発とPCシミュレーション. 中央農研研究報告 12: 1-25.<BR>
著者
後藤 伸之 吉村 直人 萱野 勇一郎 渡辺 享平 林 美由 青池 美穂 白波瀬 正樹 脇屋 義文 政田 幹夫
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.28, no.4, pp.401-406, 2002-08-10 (Released:2011-03-04)
参考文献数
5
被引用文献数
1

A heparin lock is technique performed in order to prevent blood coagulation in the needle detained in the vessel, or a catheter. In Japan, when we perform a heparin lock, a heparin injection is diluted with physiological salt solution before use. We need to use prefilled syringes with diluted heparin. We received a sample of this product. We investigated the user-friendliness of the product. From our results, the prefilled syringe with the diluted heparin was found to be useful. Furthermore, when we use the prefilled syringe with diluted heparin, patient safety is increased.
著者
淺間 一 佐藤 雅俊 後藤 伸之 嘉悦 早人 松元 明弘 遠藤 勲
出版者
The Robotics Society of Japan
雑誌
日本ロボット学会誌 (ISSN:02891824)
巻号頁・発行日
vol.15, no.7, pp.1043-1049, 1997-10-15 (Released:2010-08-25)
参考文献数
16
被引用文献数
5 5

A new type of cooperation called mutual handling is introduced in this paper, which enables a multi-robot system to achieve an advanced functionality that cannot be realized by a single robot, and as an application of mutual handling, a method of cooperative transportation for two autonomous mobile robots to climb over a large step by operating each forklifts cooperatively is proposed, which cannot be overcome by a single robot. Then, a forklift mechanism for mutual handling is designed, and two autonomous mobile robots equipped with the forklifts are developed. Finally, a cooperative transportation method in which two autonomous mobile robots are controlled based on communication is presented, and the step-climbing motion by cooperative transportation is proved feasible by showing the experimental results using the developed omni-directional mobile robots.
著者
根來 寛 矢野 良一 谷 大輔 渡辺 享平 塚本 仁 五十嵐 敏明 中村 敏明 脇屋 義文 後藤 伸之 横山 照由 政田 幹夫
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.34, no.4, pp.320-327, 2008 (Released:2009-09-04)
参考文献数
23
被引用文献数
2 1

During cancer chemotherapy,myelosuppression is a frequently observed toxicity manifestation which may sometimes cause severe infections.In this regard,though leukopenia-induced infections are more closely related to neutrophil counts than leukocyte counts,it is important to evaluate both leukocyte counts and neutrophil counts as markers of myelosuppression.Neutrophil counts,however,are sometimes estimated to be half leukocyte counts without conducting differential leukocyte counts.In the present study,the authors evaluated the necessity of differential leukocyte counts during cancer chemotherapy using pooled laboratory data at the University of Fukui Hospital.Variation in the percentage of neutrophils in leukocytes was observed in each leukocyte range,with the neutrophil count decreasing in pace with decreases in the leukocyte count.As an alternative index to the neutrophil count,the utility of the leukocyte count is thus considered to be low in cancer chemotherapy.There was also a divergence between adverse event grade between neutrophil and leukocyte numbers.In addition,neutrophil counts in 14.8% of the patients (26)were less than 1000/μL in spite of the fact that their leukocyte counts were higher than 3000/μL,and it was noted that 23 of them had undergone a paclitaxel-containing regimen.These results suggested that leukocyte differential counts should be measured during cancer chemotherapy,especially during the nadir period and when receiving chemotherapy containing paclitaxel.
著者
矢野 良一 中村 敏明 谷 大輔 西里 洋平 後藤 伸之 脇屋 義文 政田 幹夫
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.33, no.12, pp.998-1002, 2007 (Released:2009-09-04)
参考文献数
9
被引用文献数
3 5

The purpose of this study was to evaluate the quality of the original and 3 generic formulations of Iopamidol injection.To do this,the free iodine concentration and osmotic pressure were measured.In addition,impurities were tested for using high performance liquid chromatography-tandem mass spectrometry.There were no major differences between the original and generic formulations as regards free iodine concentration and osmotic pressure measurements,though one lot of the original formulation failed the free iodine concentration test.However,in the HPLC analysis,some substances not present in the original product were detected in the generic formulations.One of them was identified as DM 1/2,a substance related structurally to Iopamidol.
著者
岩出 賢太郎 下路 静佳 正木 秀典 酒井 隆全 田辺 公一 後藤 伸之 大津 史子
出版者
公益社団法人 日本薬学会
雑誌
YAKUGAKU ZASSHI (ISSN:00316903)
巻号頁・発行日
pp.18-00205, (Released:2018-12-05)
参考文献数
19

We investigated the possibility that having pharmacists give asthma patients informational sheets on climate and environmental changes at insurance pharmacies during patient counseling might prevent the worsening of asthma symptoms. Patients with hyperlipidemia were comparative subjects. We created informational sheets about climate and environmental changes and their influence on asthma. During patient counseling, pharmacists gave them to all asthma patients who visited insurance pharmacies over a period of 2 months, between November and December 2017. Based on previous studies, we called days which showed certain climate or environmental changes as compared to the previous day “change days”. We compared the number of visiting patients on change days after preventative information was provided (between January and March 2018) with the number before information was provided (between January and March 2017). In addition, we compared those numbers with the number of patients who visited the target pharmacies between January and March 2016 in order to examine the influence of yearly climate change. The same procedure was used with hyperlipidemic patients. The number of visiting asthma patients after information was provided significantly decreased (5.1±2.1, p=0.03) compared with the number before information was provided, between January and March 2017 (6.1±2.8). The number of aforementioned visits compared to those between January and March 2016 also significantly decreased (p=0.01). Our results suggest that preventative information about climate and environmental changes provided by pharmacists during patient counseling might influence the number of asthma patient visits and prevent the exacerbation of their symptoms.
著者
法山 徹 勝木 道夫 後藤 伸介 中村 立一
出版者
東海北陸理学療法学術大会
雑誌
東海北陸理学療法学術大会誌
巻号頁・発行日
vol.28, 2012

<b>【目的】 </b>超音波治療(US)は、局所へ理学療法(PT)の一手段として用いられ、その生理学的効果としては、コラーゲン組織の伸張性増大や疼痛の軽減等が報告されている。しかし、臨床においては関節可動域(ROM)制限に遭遇する頻度は比較的多いものの、USがその改善に寄与したとする報告は少ない。そこで、本研究では腱板断裂術後患者に対するUSがROM改善に及ぼす効果を検証することを目的とした。<br><b>【方法】 </b>症例は50歳代の男性であり、広範囲腱板断裂に対し、関節鏡視下腱板修復術(大腿筋膜を用いたパッチ法)を施行された症例であった。術後3ヶ月にて、大工への職業復帰を目標に当院に紹介され、初回評価時の日本整形外科学会肩関節疾患治療成績判定基準(JOA score)は66.5点、肩関節自動屈曲ROMは95°であった。研究デザインはABAとし、期間Aは通常の運動療法のみを行い、期間Bは運動療法とUSの双方を行い、AとBを2週間ずつ其々週3回の介入で交互に実施した。期間BにおけるUSは、Ultrasonic Apparatus Model ES-1(OG技研社製)を使用し、周波数は1MHZ、出力は1.2W/㎝2、施行部位は肩甲骨内側縁(肩甲棘~下角間)、照射時間は10分間とし移動法にて実施した。また、運動療法については肩甲上腕関節及び肩甲胸郭関節のROM運動、胸椎モビリゼーション、肩甲骨周囲筋のリラクゼーション及び自主運動指導を期間A, Bとも同様に行った。評価は、PT前の肩関節自動屈曲ROMとし、初回Aの前(以下preA)、Bの前(以下preB)、2回目Aの前(以下preA&rsquo;)、2回目A終了翌日(以下post A&rsquo;)に行い、2回測定した低値のものを採用した。結果の処理は、PT前の肩関節自動屈曲ROMについて各セッションの前後での変化率(%)を算出した。<br><b>【説明と同意】 </b>患者には、本研究の趣旨を説明し同意を得て行った。<br><b>【結果】 </b>preA, preB, preA&rsquo;、post A&rsquo;における肩関節自動屈曲ROM(°)は、各々120, 125, 145, 135であった。ROM改善率は、期間Aで104.1%、期間Bで116.0%、期間A&rsquo;で96.4%であり、運動療法にUSを併用した期間で改善する傾向を示した。また、期間A&rsquo;より大工への職業復帰となった。<br><b>【考察】 </b>本研究により、腱板断裂術後患者に対して運動療法にUSを併用することはROM改善に有効であることが示唆された。今回の症例ではUSを肩甲骨内側縁に施行していたが、これは同部に生活上での倦怠感を訴えていたことや圧痛が出現していたことから挙上の阻害因子と考えたため行った。USの併用によりROMが改善したことについては、僧帽筋や菱形筋等の肩甲骨内側組織の伸張性が改善したことにより肩甲骨上方回旋が促通されたためと考えた。また、期間A&rsquo;においては、ROMが低下する傾向を示していたが、職業復帰により急激に上肢の運動量が増し、仕事後の疼痛増強もみられていたため職業復帰による過用が原因と考えた。<br> 今後は、USの実施方法(筋収縮の併用や施行筋の肢位、プラセボ化等)について、より効果的な方法を検討していくことが必要と考えた。<br><b>【まとめ】 </b>腱板断裂術後患者に対してUSの有効性を検証した。運動療法にUSを併用することは、ROM改善に有効であることが示唆された。