Edutainment tools for initial education of type-1 diabetes mellitus: initial diabetes education with fun.

Purpose: Appropriate initial education for type-1 diabetes mellitus patients is important to prevent late complications. However, type-1 diabetic children have not appreciated traditional learning methods since they rarely contain the elements of fun and interactivity. In this study, we developed, implemented and evaluated a preliminary version of edutainment tools for initial education for type-1 diabetic children.

Physicians' attitudes toward anticoagulant therapy in patients with chronic atrial fibrillation.

Introduction: Although many clinical trials have demonstrated that anticoagulant therapy substantially reduces the risk of ischemic stroke in patients with atrial fibrillation (AF), some physicians are reluctant to use anticoagulants. We investigated attitudes of physicians in Japan toward anticoagulant therapy in chronic AF patients.

Methods: We conducted a survey at the annual meeting of the Japanese Society of General Medicine.

Pseudohyperkalaemia at commercial laboratories in Japan: a questionnaire survey.

Background: Pseudohyperkalaemia caused by recentrifugation after storage or delay in separation of serum from blood cells is not uncommon. The purpose of this study was to audit pseudohyperkalaemia at commercial laboratories in Japan.

Methods: A questionnaire asking about how samples are handled for potassium measurement and information on pseudohyperkalaemia was sent to 431 commercial laboratories.

Prognostic factors for the development of gangrenous cholecystitis.

Background: The operative morbidity and mortality for patients with gangrenous cholecystitis (GC) remains high. Our objective was to identify preoperative prognostic factors for GC in order to distinguish this subset of patients with acute cholecystitis (AC).

Methods: From 1/98 to 11/01 the medical records of patients who presented with the diagnosis of AC were reviewed.

Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis.

Background: Many studies have investigated the usefulness of adenosine deaminase activity (ADA) in pleural fluid for the early diagnosis of tuberculous pleurisy. To summarize the diagnostic characteristics of ADA we undertook a meta-analysis using a summary receiver operating characteristic (SROC) curve method.

Methods: Data sources were MEDLINE (1966-1999), the Cochrane Library and bibliographies of review and original articles.

Impact of social functioning and vitality on preference for life in patients with Parkinson's disease.

The determinants of preference for life in patients with Parkinson's disease are not well known. We assessed the effect of functional status on the preference for life as measured by the time trade-off method with a 10-year life span. Our survey was based on a random sample of 1,200 patients from the Japanese Association of Patients with Parkinson's Disease.

Study design, statistical method, and level of evidence in Japanese and American clinical journals.

Clinical articles published in Japanese journals are said to be characterized by poor study design, less sophisticated statistics, and producing few high-grade clinical evidences. Two American and two Japanese medical journals, published in 1990, 1993, 1996, and 1999 were compared to find out the differences regarding study design, statistical methods, and level of clinical evidence of original articles and synthetic studies. There were 1689 original articles in American and 308 in Japanese joumals.

Impact of sex and its interaction with age on the management of and outcome for patients with acute myocardial infarction in 4 Japanese hospitals.

Background: Several studies from the United States and from European countries have detected sex and age differences in clinical characteristics, management, and outcomes of acute myocardial infarction. The aim of this study was to determine how sex and age influence the management of and outcome for patients with acute myocardial infarction in Japan.

Methods: A retrospective cohort study was performed by means of patient chart review at 4 teaching hospitals in Japan.

Is Bacillus Calmette-Guerin revaccination necessary for Japanese children?

Background: Bacillus Calmette-Guerin (BCG) revaccination has been implemented in Japan among tuberculin-negative first grade primary and first grade junior high school students for decades. Controversies regarding the effectiveness of BCG revaccination and low incidence of tuberculosis (TB) among Japanese children prompted this study.

Methods: Cost-effectiveness and cost-benefit analyses were conducted for a cohort of schoolchildren who underwent revaccination during 1996.

Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training.

Background: Human patient simulation (HPS) has been used since 1969 for teaching purposes. Only recently has technology advanced to allow application to the complex field of trauma resuscitation. The purpose of our study was to validate an advanced HPS as an evaluation tool of trauma team resuscitation skills.

In-patient interventions supported by results of randomized controlled trials in Japan.

Objective: To determine to what extent the results of randomized controlled trials (RCTs) support medical interventions for in-patients at the department of general medicine of a university hospital in Japan.

Design: Retrospective analysis. By reviewing discharge summaries, two physicians first independently decided on patients' respective primary problems at admission and up to two secondary problems.

Interpretation of and preference for probability expressions among Japanese patients and physicians.

Background: Patients and physicians often communicate using qualitative probability expressions that describe expected outcomes or risks of a medical intervention without knowing whether or not they share the same understanding.

Objective: The aim of the present study was to determine interpretations of qualitative probability expressions in clinical settings by Japanese patients and physicians as well as their assessments and preferences about physicians' use of such expressions.

Methods: One hundred and sixty-eight consecutive patients aged 16 years or older, who attended a university hospital during a 2-week period in 1999, and 156 physicians recruited through the Japanese General Medicine Research Network participated in this cross-sectional survey, using a self-administered questionnaire.