Publications by authors named "Satoshi Hirahara"

Article Synopsis
  • * Qualitative analysis revealed four main themes: fear of personal protective equipment (PPE), loneliness, dissatisfaction with behavioral restrictions, and family interference with care services.
  • * The findings suggest that preventive measures during the pandemic led to increased social isolation and mental distress among people with dementia, compounded by misunderstandings of these measures by both patients and their families.
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This quick literature review aimed to organize information on the detailed components of total pain in older people with advanced dementia in a holistic manner. The authors analyzed qualitative data from relevant clinical guidelines or textbooks, focusing on certain types of pain and distress in older people with advanced dementia, followed by an expert panel review by research team members. In the search, the authors defined a person with advanced dementia as having a functional assessment staging tool scale score greater than or equal to six.

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Aim: Older adults at the end-of-life stage receiving home visits from physicians often experience symptoms such as dyspnea, pain and fatigue, among others. This study aimed to investigate the practices and opinions of physicians providing home visits regarding palliative care for older adults with respiratory symptoms due to non-malignant diseases in Japan.

Methods: A nationwide questionnaire survey on home palliative care for non-cancer chronic respiratory diseases was sent to 2988 home-care physicians in 2020 through postal mail and/or email.

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A previous pooled analysis demonstrated significant relief of breathlessness following opioid administration in patients with chronic obstructive pulmonary disease. However, in clinical practice, it is important to know the characteristics of patients responding to opioids, the best prescription methods, and the evaluation measures that can sufficiently reflect these effects. Thus, we performed a systematic review of systemic opioids for non-cancer chronic respiratory diseases.

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Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy.

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Aim: Many older people with end-stage dementia die of pneumonia, but the details of their distress have been unclear. The present study clarified the distress experienced by such individuals due to pneumonia.

Methods: We searched for literature corresponding to 5 clinical questions (CQs) concerning including "What distress is experienced by older people with end-stage dementia due to pneumonia (CQ1) ?" using a search formula with the Web version of the Central Medical Magazine, MEDLINE (STN)/EMBASE (STN), Cochrane Library, and extracted 604 articles.

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Background: Metachronous pancreatic and gallbladder cancer is a rare condition and has a dismal prognosis. Herein, we present a patient with triple metachronous primary pancreatic and gallbladder cancer associated with pancreaticobiliary maljunction who achieved long-term survival after undergoing repeat curative surgery.

Case Presentation: A 65-year-old female patient with advanced gallbladder cancer associated with pancreaticobiliary maljunction underwent extended cholecystectomy with extrahepatic bile duct resection.

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A 79-year-old woman visited our hospital complaining of bloating. An abdominal enhanced CT scan revealed pancreatic body cancer with cancerous ascites and multiple liver metastases. We started gemcitabine(GEM)plus nab-paclitaxel chemotherapy.

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Primary palliative care is essential for the continuity of care in severe COPD. This study aimed to identify essential factors and aspects to enhance the quality of primary palliative care for adults with severe COPD living in the community. Interviews with medical professionals from six institutions located in two major metropolitan areas in Japan were conducted, and these interviews were analyzed by using a qualitative content analysis approach.

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Since the end of 2019, a life-threatening infectious disease (coronavirus disease 2019: COVID-19) has spread globally, and numerous victims have been reported. In particular, older persons tend to suffer more severely when infected with a novel coronavirus (SARS-CoV-2) and have higher case mortality rates; additionally, outbreaks frequently occur in hospitals and long-term care facilities where most of the residents are older persons. Unfortunately, it has been stated that the COVID-19 pandemic has caused a medical collapse in some countries, resulting in the depletion of medical resources, such as ventilators, and triage based on chronological age.

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The Japan Geriatrics Society has so far announced "The Japan Geriatrics Society Position Statement 2012" and "Guidelines for the Decision-Making Processes in Medical and Long-Term Care for the Elderly - Focusing on the Use of Artificial Hydration and Nutrition" related to end-of-life care for older adults. In 2018, the Ministry of Health, Labor and Welfare revised the "Guidelines for the Decision-Making Processes in Medical and Long-Term Care in the End of Life," recommending the practice of advance care planning (ACP). This was the first time when the Japanese government publicized its stance on ACP.

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The prognosis of unresectable gastric cancer remains poor. Multidisciplinary treatment of unresectable gastric cancer is, therefore, thought to be essential for improving patients' outcomes. Here, we report a successful case of multidisciplinary therapy for unresectable gastric cancer.

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Nivolumab is one of the immune checkpoint inhibitors available for chemotherapy-resistant gastric cancer. There have been few reports of confirmed prominent shrinkage of the primary tumor and some reports of prolonged antitumor effect after discontinuance of the drug, but it is not universal. A 67-year-old male was admitted to our hospital and diagnosed with metastatic gastric cancer that had spread to the bilateral lobe of the liver, distant lymph nodes, and peritoneum.

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Objectives The importance of social capital in promoting interprofessional collaborations is well known. This study examined the effects of an interprofessional educational program for homecare professionals on building social capital in terms of homecare in an urban area.Methods The program was conducted at Kita Ward, Tokyo, from July 2014 to January 2015.

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Furnished cages for laying hens have advantages in allowing normal behaviors and maintaining productivity. As the cost of introduction is a barrier for farms, we developed furnished cages that re-use conventional cages. To determine the minimum and functional cage design, we compared six designs, combinations of two floor designs (artificial turf or wire cage floor) and three screening designs in the integrated area (no screening, one entrance side or four sides).

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Objective To examine the short-term effects of an inter-professional educational program developed for physicians and other home care specialists to promote home care in the community.Methods From March 2012 to January 2013, an inter-professional educational program (IEP) was held four times in three suburban areas (Kashiwa city and Matsudo city in the Chiba prefecture, and Omori district in the Ota ward). This program aimed to motivate physicians to increase the number of home visits and to encourage home care professionals to work together in the same community areas by promoting inter-professional work (IPW).

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Article Synopsis
  • Patients in Japan, particularly the elderly requiring home medical care, are increasingly facing challenges due to a lack of device replacement services, which can force them to seek hospital visits.
  • A cross-sectional survey was conducted in 2013 targeting clinics and nursing stations providing home care, revealing response rates of 16.5% for clinics and 31.3% for nursing stations.
  • The analysis indicated that the number of clinic staff and the availability of 24-hour care significantly impacted the replacement of medical devices like gastrostomy tubes and tracheal cannulas, highlighting the need for better collaboration between practices to improve home care.
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Aim: The present study investigated the association between the structure of catheter replacement services in home medical care settings and regional characteristics.

Methods: An anonymous self-administered questionnaire was carried out from August to September 2013. Participants were physicians from 5338 clinics that provided medical care services at home, and nurses from 1619 home-visit nursing stations in Tokyo and three adjoining prefectures.

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From May to October 2011, we conducted an 8-day homecare educational program for physicians, dentists, pharmacists, visiting nurses, long-term care managers, and hospital staff in Kashiwa city, Chiba, which was primarily intended to increase home visits by physicians. The characteristics of the program were as follows: 1) active and busy community physician participation, 2) attendance of practical training by physicians, 3) interprofessional discussion, 4) recruitment of participants from the same city, 5) recommendation of participant recruitment by a community-level professional association such as Kashiwa City Medical Association. By comparison of the pre- and post-program questionnaires completed by participants, the motivation for homecare practice, knowledge about homecare, and interactions with other professionals have increased.

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Background: We aimed to clarify the factors affecting outcomes of home care for patients with malignant diseases.

Methods: Of 607 patients who were treated in 10 clinics specialized in home care between January and December 2007 at Chiba, Fukuoka, Iwate, Kagoshima, Tochigi and Tokyo prefectures across Japan, 346 (57%; 145 men and 201 women) had malignant diseases. We collected information on medical and social backgrounds, details of home care, and its outcomes based on their medical records.

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To increase the validity of evaluations and facilitate expansion and maintenance of assessment systems, we constructed a database of studies on the welfare of laying hens around the world. On the basis of this database, we devised a science-based welfare assessment model. Our model includes measurements, levels and weightings based on the scientific studies in the database, and can clarify the advantages and disadvantages of housing systems for laying hens from the viewpoint of the five freedoms.

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Objective: There is a lack of sufficient information on the employment of home care for the treatment of hematologic malignancies.

Methods: We provided home care to 580 patients from 1 January through 31 October 2007. Patients with hematologic malignancies were selected from these 580 patients; subsequently, by reviewing their medical records.

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In order to clarify the issues regarding home hospice for patients with non-cancer disorders, the patients' death at home was compared with that of terminal cancer patients treated in our clinic. The following results were obtained: In the non-cancer disorder group, the number of deaths of female patients was greater than that of male patients. In this same group, the average age of patients at death was greater by 6.

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