[Role of nurses at the Medical Support Center in the discharge and in-home supports].

The Medical Support Center(MSC)of the A university hospital encourages inpatients to leave the hospital and outpatients to live better at home. The medical social workers and the nurses cooperate to achieve these aims. The role of the nurses at the Medical Support Center is to collect information regarding the medical services and the welfare systems, and to provide the patients and their families with this information.

[Education of clinical pharmacy specialists in critical care in Japan].

In Japan, recent initiation of the reimbursement from the government to monitor patients in intensive care unit (ICU) and the foundation of certified emergency medicine and critical care specialist resulted in the increased number of ICU pharmacists. Because most pharmacy schools in Japan have provided few lectures or rotations related to critical care, pharmacy students may think critical care is a difficult field. Pharmacy students in the United States usually have basic didactic courses for critical care such as sepsis or sedation.

[A case of MRSA infection in multiple artificial joints successfully treated with conservative medical treatment].

We report herein on a case with multiple MRSA prosthetic arthritis and osteomyelitis successfully treated medically. Our patient was a 64-year-old Japanese woman with a previous medical history of malignant rheumatoid arthritis and multiple surgical interventions with an atlantoaxial fixation in 2003, artificial joint replacement of both knee joints in 2006, and of the right hip joint in September, 2007. She was initially hospitalized due to MRSA arthritis in the right hip in October, 2007.

Decreased physical function in pre-dialysis patients with chronic kidney disease.

Background: Patients undergoing dialysis experience decreases in physical function; however, few data exist on physical function in pre-dialysis patients with chronic kidney disease (CKD). The primary objective of this study was to clarify physical function in pre-dialysis patients according to CKD stage.

Methods: This was a cross-sectional study of 120 ambulant pre-dialysis CKD stage 2 or higher patients (85 male, 35 female; mean age 66.

Determination of the effectiveness of accelerometer use in the promotion of physical activity in cardiac patients: a randomized controlled trial.

Objective: To investigate the effect of the self-monitoring of physical activity by hospitalized cardiac patients attending phase I cardiac rehabilitation (CR).

Design: Randomized controlled trial.

Setting: University hospital CR program.

Relation between maximum phonation time and exercise capacity in chronic heart failure patients.

Background: Patients with chronic heart failure (CHF) commonly fatigue easily due to low peak oxygen uptake (peak VO(2)), an important index of exercise capacity. Maximum phonation time (MPT) is widely used to evaluate maximum vocal capabilities because it is non-invasive, quick, and inexpensive.

Aim: The aim of this study was to determine the relation between MPT and exercise capacity, and MPT required to attain an exercise capacity of ≥5 metabolic equivalents (METs) in CHF outpatients.

Relation between physical activity and exercise capacity of ≥5 metabolic equivalents in middle- and older-aged patients with chronic heart failure.

Purpose: Patients with exercise capacity of <5 metabolic equivalents (METs) are considered to have a high risk of death. The aim of this study was to determine age-related differences in physical activity associated with an exercise capacity of ≥5 METs in chronic heart failure (CHF) outpatients.

Methods: We enrolled 157 stable CHF patients (79.

Upper and lower extremity muscle strength levels associated with an exercise capacity of 5 metabolic equivalents in male patients with heart failure.

Purpose: Exercise capacity of fewer than 5 metabolic equivalents (METs) has been associated with high risk of death and poor physical functioning in male patients with heart failure (HF). Therefore, we aimed to determine upper and lower extremity muscle strength levels required to attain an exercise capacity of 5 or more METs in male outpatients with HF.

Methods: We enrolled 148 male HF patients (age 60.

Relation between sleep quality and physical activity in chronic heart failure patients.

To determine self-reported sleep quality-related differences in physical activity (PA) and health-related quality of life (HRQOL) and target values of PA for high-quality sleep in chronic heart failure (CHF) outpatients, 149 CHF outpatients (mean age 58 years) were divided into two groups by sleep-quality level determined via self-reported questionnaire: shallow sleep (SS) group (n = 77) and deep sleep (DS) group (n = 72). Steps were assessed by electronic pedometer, HRQOL was assessed with the Short Form 36 (SF-36) survey, and data were compared between groups. PA resulting in high-quality sleep was determined by receiver-operating characteristics curves.

Cardiac rehabilitation outcome following percutaneous coronary intervention compared to cardiac surgery.

To examine differences in objective and subjective outcomes in outpatients undergoing percutaneous coronary intervention (PCI) performed for acute myocardial infarction versus cardiac surgery (CS) following a phase II cardiac rehabilitation (CR). Longitudinal observational study of 437 consecutive cardiac outpatients after 8 weeks of phase II CR. Patients were divided into the PCI group (n = 281) and CS group (n = 156).

Age-related differences in physiologic and psychosocial outcomes after cardiac rehabilitation.

Objective: To examine differences in physiologic and psychosocial outcomes between age groups after an exercise-based supervised-recovery phase II cardiac rehabilitation outpatient program.

Design: This is a longitudinal observational study. The study assessed 442 consecutive cardiac patients.

Gender-related differences in clinical characteristics and physiological and psychosocial outcomes of Japanese patients at entry into phase II cardiac rehabilitation.

Objective: To examine gender differences in clinical characteristics and physiological and psychosocial outcomes at entry into phase II cardiac rehabilitation.

Design: Cross-sectional study.

Subjects: The study comprised 442 consecutive patients with cardiac diseases assessed at entry into a phase II cardiac rehabilitation programme.

Muscle strength in relation to disease severity in patients with congestive heart failure.

Objective: Indices of exercise capacity such as peak oxygen uptake (VO2peak) and muscle strength are important in association with reduced mortality. The present study compared differences in VO2peak and muscle strength indices (grip strength and knee extensor and flexor muscle strength) with disease severity and investigated the relation of these variables in congestive heart failure (CHF) patients.

Design: The study comprised 102 patients with stable CHF (93 men, age 61.

Inhibitory effect of alprostadil against sevoflurane-induced myometrial relaxation in rats.

Purpose: For anesthetic management of cesarean sections, regardless of the use of regional or general anesthesia, it is crucial to achieve sufficient uterine contraction immediately following the delivery of an infant in order to reduce excessive bleeding. No previous study has investigated the ability of alprostadil, a synthesized prostaglandin, to inhibit myometrial relaxation induced by volatile anesthetics. The aim of the present study was to investigate the inhibitory effects of alprostadil on sevoflurane-induced myometrial relaxation using myometrial strips isolated from pregnant rats.

Use of hand-held ultrasonography to confirm the correct placement of a central venous catheter tip.

To avoid severe complications resulting from malpositioning of a central venous catheter, removal and recannulation of the catheter may be necessary, thus wasting medical equipment and increasing stress on the patient. Therefore, central venous catheters should be inserted correctly the first time. We tested whether real-time hand-held ultrasound-guided confirmation of the location of the tip of a central venous catheter inserted from the femoral vein could reduce the rate of malpositioning.

The effects of unsupervised exercise training on physical activity and physiological factors after supervised cardiac rehabilitation.

Exercise maintenance after supervised cardiac rehabilitation is important in maintaining both physical activity and physiological factors, such as peak and muscle strength (MS), associated with reduced mortality. However, there is no evidence of the effects of unsupervised exercise training and MS training on physical activity and physiological factors after supervised cardiac rehabilitation of Japanese cardiac patients. We conducted a randomized, controlled trial to evaluate the effect of unsupervised exercise training on physical activity and selected physiological factors after supervised cardiac rehabilitation.

Effect of the self-monitoring approach on exercise maintenance during cardiac rehabilitation: a randomized, controlled trial.

Objective: To evaluate the effect of the self-monitoring approach (SMA) on self-efficacy for physical activity (SEPA), exercise maintenance, and objective physical activity level over a 6-mo period after a supervised 6-mo cardiac rehabilitation (CR) program.

Design: We conducted a randomized, controlled trial with 45 myocardial infarction patients (38 men, seven women; mean age, 64.2 yrs) recruited after completion of an acute-phase, exercise-based CR program.

Physiological and health-related quality of life outcomes following cardiac rehabilitation after cardiac surgery.

We investigated the changes of an 8-week cardiac rehabilitation (CR) program on physiological outcomes and health-related quality of life (HRQL) in Japanese cardiac surgery patients. Subjects were 47 consecutive outpatients (32 men, 15 women; mean age 59.4 ± 12.

Long-term exercise maintenance, physical activity, and health-related quality of life after cardiac rehabilitation.

Objective: The purpose of this study was to determine exercise maintenance rate, leisure-time objective physical activity level, and health-related quality of life in relation to exercise maintenance over the 6-mo period after a supervised 5-mo recovery-phase cardiac rehabilitation program in acute myocardial infarction patients. The study also investigated whether exercise maintenance resulted in reproducible health-related quality-of-life outcomes comparable with those of the Japanese normal population.

Design: This observational study comprised 109 acute myocardial infarction patients (89 men, 20 women; mean age, 63.

[Von Willebrand factor-cleaving protease activity in patients of collagen disease with antiphospholipid antibodies].

Acquired thrombotic thrombocytopenic purpura (TTP), characterized by widespread thrombus formation in the microcirculation, is a ponderous complication of antiphospholipid syndrome. Recently, von Willebrand factor-cleaving protease (VWF-CPase) activity has been reported as a possible determinant for the occurrence of TTP. To clarify the role of VWF-CPase in the thrombus formation associated with antiphospholipid syndrome, we investigated plasma VWF-CPase activity in patients of collagen diseases with lupus anticoagulant (LA).

[Clinical significance of a new fibrinogen/fibrin degradation products(FDP) test using plasma samples for the diagnosis of fibrinogenolysis and fibrinolysis].

Recently, a new fibrinogen/fibrin degradation products(FDP) test using monoclonal antibodies against FDP(LPIA FDP-P: FDP-P) has been developed, which is able to measure FDP directly in plasma. The objective of this study is to clarify clinical significance of the test in the diagnosis of fibrinogenolysis and fibrinolysis in comparison with a conventional FDP test using polyclonal antibodies against fibrinogen(FDP-S) and D-dimer test using monoclonal antibodies against D-dimer(D-D). The monoclonal antibodies used in FDP-P test was shown to recognize fragment X, Y and D1 derived from fibrinogen digested by urokinase, and was also to recognize XDP fragments, D-dimer and D derived from cross-linked fibrin digested by tissue plasminogen activator using SDS-PAGE and immunoblotting analysis.

The Effects of Stride Walking on Cardiovascular and Electromyographic Responses under Different Conditions in Velocity or Grade in Healthy Young Women.

This study was conducted to investigate the effects of stride walking on cardiovascular and electromyographical responses on a treadmill in healthy young female (mean age of 23.0 yrs, height of 156.2 cm and weight of 50.

Mechanism of increase in anaerobic threshold during recovery phase in patients with acute myocardial infarction.

The contribution of venous return to the increase in anaerobic threshold (AT) in patients with acute myocardial infarction (AMI) was investigated. Twenty-seven patients with uncomplicated AMI underwent supine and sitting cardiopulmonary exercise testing, and 10 out of these 27 patients performed constant-workload tests in which cardiac output before and after a phase II program was measured. Data from 8 patients were eliminated because of restenosis after direct percutaneous transluminal coronary angioplasty.

Cardiopulmonary responses at various angles of cycle backrest inclination.

The purpose of this study was to evaluate cardiopulmonary responses during submaximal cycle exercise at various angles of backrest inclination. Ten healthy Japanese men of mean age 25.9 yrs, height 170.