Reduced renal function is associated with prolonged hospitalization in frail older patients with non-severe pneumonia.

Objective: Pneumonia is a disease with high morbidity and mortality among older individuals in Japan. In practice, most older patients with pneumonia are not required ventilatory management and are not necessarily in critical respiratory condition. However, prolonged hospitalization itself is considered to be a serious problem even in these patients with non-critical pneumonia and have negative and critical consequences such as disuse syndrome in older patients.

Behçet's Disease with Extremely High Levels of Urinary β2-Microglobulin after Non-Steroidal Anti-Inflammatory Drug Treatment.

Behçet's disease is an inflammatory disease which manifests itself as various symptoms, such as uveitis, oral and genital aphthae, erythema nodosa, gastro-intestinal ulcerations and encephalopathy. Among the manifestations, renal dysfunction is reported in some percentage of the patients with this disorder. We experienced a middle-aged male with Behçet's disease who showed an extremely high level of urinary β2-microglulin, which is one of the markers of renal dysfunction, despite normal serum creatinine levels.

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer.

Japanese mortality due to colorectal cancer is on the rise, surpassing 49,000 in 2015. Many new treatment methods have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2016 for the treatment of colorectal cancer (JSCCR Guidelines 2016) were prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding between health-care professionals and patients by making these Guidelines available to the general public.

[How Long Should We Continue the Chemotherapy?-From the View Point of Health Economics].

The continuation of cancer chemotherapy was examined from the view point of the patient's economic burden and the national finance. Along with the rapid technological progress, anti-cancer drugs become more and more expensive. According to our survey, not a little patient was obliged to give up the most appropriate treatment due to some economic reasons.

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer.

Colorectal cancer is a major cause of death in Japan, where it accounts for the largest number of deaths from malignant neoplasms among women and the third largest number among men. Many new methods of treatment have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2014 for treatment of colorectal cancer (JSCCR Guidelines 2014) have been prepared as standard treatment strategies for colorectal cancer, to eliminate treatment disparities among institutions, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding among health-care professionals and patients by making these guidelines available to the general public.

Proposal for the breakdown of increased cancer healthcare cost and its improvement.

Technological progress in the field of cancer treatment can be expected to accelerate in the future, giving hope to such patients. At the same time, there is concern that cancer care will become more expensive. It is indispensable to minimize the economic burden of patients to deliver technological advances in treatment.

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer.

Colorectal cancer is a major cause of death in Japan, where it accounts for the largest number of deaths from malignant neoplasms in women and the third largest number in men. Many new treatment methods have been developed over the last few decades. The Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer (JSCCR Guidelines 2010) have been prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding between health-care professionals and patients by making these Guidelines available to the general public.

[Economic burden of cancer patients undergoing oral chemotherapy].

Due to constant medical advancement, the cost of cancer treatment has been spiraling and the economic burden of the patient has increased. In view of this, it is important to ease the patient's economic burden while pushing for high quality cancer treatment. We carried out a national level investigation with cancer patients and their medical doctors in charge and reviewed the policy to minimize the patients' burden.

The cost-effectiveness of risedronate treatment in Japanese women with osteoporosis.

We constructed a mathematical model for assessing the cost-effectiveness of providing BMD (bone mineral density) scans to Japanese women aged 55 years and over and treating, with risedronate, those that are shown to be osteoporotic. Fracture rates, cost data, utility values, and the increased risks of fractures associated with T-score and vertebral fracture history were taken from published literature. We estimated the cost of fractures avoided due to risedronate treatment, allowing the net changes in cost, incorporating both intervention and fracture costs to be calculated.

Strategies for improving pediatric services in Japan.

The shortage of pediatricians and emergency medical care for children is an issue of great concern in Japan. This study attempts to identify the problems in children's medical care and their causes. With multiple secondary data sources, we found that over 80% of outpatient pediatric services were provided by clinics, that over 95% of clinics were closed on holidays, Sunday, and Saturday night, that among the children's illnesses respiratory ailments were dominant and were generally acute and required immediate treatment or consultation, and that the revenue rates from providing services for children were lower than those for adults.

Impact of hormonal therapy prior to radical prostatectomy on the recovery of quality of life.

Background: We investigated the changes in health-related quality of life (HRQOL) in patients who underwent prostatectomy (RP) with or without neoadjuvant hormonal therapy (NHT).

Methods: A total of 72 patients undergoing direct RP (DRP group) and 26 patients receiving neoadjuvant hormonal therapy (NHT group) were enrolled in the present study. The baseline interview was conducted before RP (not initiation of therapy).

Recovery of health related quality of life after radical prostatectomy in japanese men: a longitudinal study.

Background: We performed a longitudinal survey of health related quality of life (HRQOL) after radical retropubic prostatectomy (RP) in Japanese men with localized prostate cancer.

Methods: The present study started with self-reported HRQOL assessments provided by 72 patients who received only RP. The RAND 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index were administered before and 3, 6 and 12 months after RP.

Health related quality of life in Japanese men after radical prostatectomy or radiation therapy for localized prostate cancer.

Background: We performed a retrospective survey of general and disease specific health-related quality of life (HRQOL) after radical prostatectomy (RP) and external beam radiotherapy (XRT) in Japanese men.

Methods: A total of 186 patients underwent RP and 78 underwent XRT for clinically localized prostate cancer between 2000 and 2002. We measured the general and disease specific HRQOL with the MOS 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index, respectively.

[The perioperative charge equivalence of radical prostatectomy with 1-year follow up since the diagnosis of prostate cancer].

We assessed the 1-year charges in the group of patients undergoing radical prostatectomy and the changes in hospital costs and resource use following implementation of a clinical care path. A total of 69 consecutive men treated with radical prostatectomy for clinically localized prostate cancer were enrolled in the study. Hospital and outpatient records were analyzed for each patient in regard to preoperative, operative and postoperative charges of a 12-month period.

Health-related quality of life after radical prostatectomy in Japanese men with localized prostate cancer.

Purpose: We evaluated retrospectively health-related quality of life (HRQOL) after radical prostatectomy (RP) in Japanese men with localized prostate cancer.

Methods: The study was based on self-reported HRQOL of 280 patients. Patients were divided into seven groups: time 0 (T0), baseline before operation; T1, 1-3 months after RP; T2, 4-6 months after RP; T3, 7-12 months after RP; T4, 13-24 months after RP; T5, 25-36 months after RP; and T6, more than 36 months after RP.

[Economic analysis of adverse events in cancer treatment].

Faced with limited resources and the desire to improve the quality of cancer care, there is an increasing interest among physicians in maximizing gains in cancer treatment. This paper discusses where to find cost-benefit estimates for a host of adverse events in cancer treatments. In order to clarify the relationship between the input resources and economic effects of supportive therapies against adverse events, we developed a system model, similar to the Marcov model, of prognosis of principal seven cancers and analyzed the balance of patient labor productivity (Benefit) and accumulated cancer care costs (Cost).