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1.
Nagoya J Med Sci ; 80(4): 465-473, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30587861

RESUMEN

To minimise the global burden of diabetes, the awareness of appropriate intervention methods for diabetes education and practice is essential. This project is the first international interprofessional education (IIPE) for the awareness of diabetes, with a focus on patient-centred care wherein three medical and four pharmacy students from Japan and one medical, two pharmacy, two nutrition and one occupational therapy (OT) student from Scotland participated. We described IIPE effects using interdisciplinary education perception scale (IEPS) before and after the programme among Scottish and Japanese students. University of Aberdeen/ Robert Gordon University and Nagoya University developed and established a shared online platform that provided knowledge to students on diabetes in both languages. We developed a case-based scenario that reflected diabetes care in each country using a standardised patient (SP). Lastly, a student-led live webinar was conducted on 14 November 2014 (the World Diabetes Day) to discuss and exchange care methods for SP. Each participating national team presented their care plan and all students discussed the diabetic care plan online. Both Japanese and Scottish teams were able to accurately assess the patient's condition and empathise with the SP. In conclusion, all participants learned that interprofessional collaboration was clearly required for diabetes management focused on patient-centred care. All participants appreciated the differences in the approach of the two countries involved because of the cultural- and health related differences. This programme was significant in raising awareness regarding the need for international interprofessional intervention on diabetes towards developing a model for live webinar IIPE.


Asunto(s)
Diabetes Mellitus , Estudios Interdisciplinarios , Atención Dirigida al Paciente/métodos , Humanos , Japón , Grupo de Atención al Paciente , Escocia , Difusión por la Web como Asunto
2.
Nagoya J Med Sci ; 80(1): 99-107, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29581619

RESUMEN

The number of patients with diabetes is increasing in Japan. Recently, Social capital (SC) has received increasing attention as a factor influencing health conditions. In the US, the relation between SC and diabetes control has been reported, but little attention has been paid to this connection in Japan. Three SC questionnaires, entitled "trust in people in a community," "social support," and "social relationships," were constructed. The subjects were adult patients with type 2 diabetes. Information on diabetic conditions, such as HbA1c, self-attainment of diet (SAD) and exercise (SAE), and complications were collected. The reliability coefficients for the SC questionnaire and factor analysis of SC were conducted. Multiple and logistic regressions were used to identify the influence of SC on diabetes control. Sixty-five patients participated in this study. The questionnaires "social support" and "social relationships" were adopted to measure Cronbach alpha coefficient. Factor analysis extracted the factors "hope to be helped (HH)," "participation in favorite events (PFE)," "sense of belonging (SB)," and "social movement (SM)." HbA1c was positively correlated with HH (P < 0.05). SAD and SAE were negatively correlated with HH (P < 0.05). SAE was positively correlated with PFE (P < 0.05). PFE reduced complication risks (P < 0.05). HH includes amae, which negatively affected self-efficacy that correlates with diabetes control. Therefore, higher HH might cause higher levels of HbA1c. PFE reduces distress and contributes to glucose control. Reduced distress through PFE might prevent complications. HH and PFE were identified as SC that influences diabetes control.

3.
Yakugaku Zasshi ; 137(6): 733-744, 2017.
Artículo en Japonés | MEDLINE | ID: mdl-28566579

RESUMEN

Collaboration with multiple healthcare professionals is important to provide safer and higher quality care. Interprofessional education (IPE) promotes the practice of team-based care. The establishment of Tsurumai-Meijo IPE, including interprofessional education and practice (IPEP) and video-teaching materials, was conducted in collaboration with school of medicine/nursing in Nagoya University and Fujita Health University, because Meijo University does not have its own clinical settings and faculties except for pharmacy. In the established Tsurumai-Meijo IPE, pharmacy, medicine, and nursing students interviewed simulated patients (SP) together or separately and practiced team-based care through Tsurumai-Meijo IPEP. Students could learn in advance and on their own about each professional's knowledge related to patient care by using video-teaching materials from the Meijo IPE homepage. Using a questionnaire survey at the end of program, this study was examined whether Tsurumai-Meijo IPEP, and video-teaching materials were useful for understanding importance of team-based care. More than 83% of students indicated that Tsurumai-Meijo IPE is useful on future clinical practice. This suggests that the program and materials are beneficial to the medical student education. In the optional survey of some clinical pharmacists, who had participated in Tsurumai-Meijo IPE before graduation, they utilized it in their work and it facilitated their work related to team-based care. Tsurumai-Meijo IPE collaborating with SP is likely to contribute to provide high quality and safe team-based care by taking advantage of specialized professional ability of healthcare professionals.


Asunto(s)
Educación Médica/métodos , Educación en Enfermería/métodos , Educación en Farmacia/métodos , Colaboración Intersectorial , Simulación de Paciente , Competencia Clínica , Femenino , Humanos , Masculino , Grupo de Atención al Paciente , Calidad de la Atención de Salud , Encuestas y Cuestionarios , Materiales de Enseñanza , Grabación de Cinta de Video
4.
Diabetes Res Clin Pract ; 78(2): 208-10, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17490777

RESUMEN

We investigated that the association of MCP-1 polymorphism at position -2518 with insulin sensitivity and insulin secretion by measuring the fasting and post-challenge glucose and insulin levels during 75g OGTT in 409 non-diabetic Japanese subjects. The blood sampling was performed before glucose loading and after 30 and 120 min. Polymorphism was evaluated by PCR-RFLP method by genomic DNA isolated from peripheral blood leukocytes. The genotype distribution was 44.8% for G/G, 46.0% for G/A and 9.2% for A/A. The plasma glucose levels were significantly increased in A/A as compared to G/G (p<0.05), but it was not compared with G/A at 120 min. The serum insulin levels were significantly increased in A/A as compared to G/A (p<0.05) or G/G (p<0.05) at 30 min. Moreover, the serum insulin levels in A/A were significantly increased compared with G/A (p<0.02) or G/G (p<0.005) at 120 min. Elevation in post-challenge glucose (120 min) and insulin levels (30 and 120 min) suggests that reduced insulin sensitivity during glucose loading occurs in subjects with A/A polymorphism. The present study demonstrates that the A/A polymorphism of the MCP-1 gene at position -2518 is associated with insulin resistance during glucose loading in non-diabetic Japanese subjects.


Asunto(s)
Glucemia/metabolismo , Quimiocina CCL2/genética , Insulina/sangre , Polimorfismo Genético/genética , Regiones Promotoras Genéticas/genética , Grupo de Ascendencia Continental Asiática/genética , Prueba de Tolerancia a la Glucosa , Humanos , Resistencia a la Insulina/genética , Japón , Persona de Mediana Edad
6.
Diabetes Res Clin Pract ; 73(3): 310-4, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16631275

RESUMEN

To investigate the relationship between oxidative stress and circulating levels of adiponectin in Japanese metabolically obese, normal-weight [MONW; BMI<25 and visceral fat area; VFA > or =100 cm2 by abdominal computed tomography (CT) scanning] men with normal glucose tolerance (NGT), we measured the plasma levels of free 8-epi-prostaglandin F2alpha (8-epi-PGF2alpha) and adiponectin in 28 MONW and 23 normal men. The plasma levels of free 8-epi-PGF2alpha were measured using a commercially available enzyme immunoassay (EIA) kit (Cayman Chemical, Ann Arbor, MI). The plasma levels of adiponectin were measured using a radioimmunoassay kit (LINCO Research, St. Charles, MO). Plasma levels of 8-epi-PGF2alpha in MONW subjects (30.4+/-4.0 pg/ml; P<0.01) were significantly increased compared to controls (8.1+/-1.3 pg/ml). The plasma levels of adiponectin were significantly decreased in MONW subjects (8.6+/-0.9 microg/ml; P<0.01) as compared to normal subjects (11.6+/-0.6 microg/ml). The plasma levels of 8-epi-PGF2alpha and adiponectin were significantly correlated in MONW (r=-0.617, P<0.01) and in all (MONW+normal) (r=-0.620, P<0.01) subjects. The plasma levels of 8-epi-PGF2alpha and adiponectin were significantly correlated after adjustment for VFA in MONW subjects (F=11.042, P<0.01). The present study showed that systemic increase in oxidative stress correlates with decreased circulating levels of adiponectin in Japanese MONW men with NGT. Although correlation does not prove causation, this observation suggests that increased oxidative stress may decrease the production of adiponectin in Japanese MONW men with NGT.


Asunto(s)
Adiponectina/sangre , Peso Corporal/fisiología , Obesidad/fisiopatología , Estrés Oxidativo/fisiología , Adulto , Glucemia/análisis , Dinoprost/sangre , Prueba de Tolerancia a la Glucosa/métodos , Humanos , Grasa Intraabdominal/metabolismo , Japón , Lípidos/sangre , Masculino , Obesidad/sangre , Obesidad/metabolismo , Radioinmunoensayo
7.
Eur J Endocrinol ; 153(3): 403-7, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16131603

RESUMEN

OBJECTIVE: To investigate the relationship between active ghrelin and oxidative stress in obese subjects. DESIGN: We measured the plasma levels of free 8-epi-prostaglandin F(2alpha) (8-epi-PGF(2alpha), a reliable and systemic marker of oxidative stress) and the active form of ghrelin in 17 obese and 17 normal subjects. The biologically active forms of ghrelin were measured using a commercially available radio-immunoassay kit and free 8-epi-PGF(2alpha) was measured using an enzyme immunoassay kit. RESULTS: The circulating level of active ghrelin was significantly decreased (20.4 +/- 2.6 vs 40.9 +/- 3.9 fmol/ml, P < 0.01) while that of 8-epi-PGF(2alpha) was significantly increased (61.5 +/- 9.6 vs 17.3 +/- 3.4 pg/ml, P < 0.01) in obese subjects compared with normal subjects. The plasma levels of active ghrelin and 8-epi-PGF(2alpha) were significantly correlated in obese (r = -0.507, P < 0.05) and in all (r = -0.577, P < 0.01) subjects. Multivariate analysis showed that the plasma levels of active ghrelin and 8-epi-PGF(2alpha) were significantly and independently correlated in all subjects (F = 7.888, P < 0.01). CONCLUSIONS: There is an inverse correlation between circulating levels of active ghrelin and oxidative stress in obesity. Low circulating levels of active ghrelin may enhance oxidative stress and the process of atherosclerosis in obese subjects.


Asunto(s)
Obesidad/sangre , Estrés Oxidativo/fisiología , Hormonas Peptídicas/sangre , Adulto , Glucemia/metabolismo , Presión Sanguínea/fisiología , Composición Corporal/fisiología , Colesterol/sangre , Dinoprost/análogos & derivados , Dinoprost/sangre , Femenino , Ghrelina , Humanos , Insulina/sangre , Masculino , Análisis Multivariante , Triglicéridos/sangre
8.
Int J Mol Med ; 16(3): 421-5, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16077949

RESUMEN

Hepatic lipase (HL) is synthesized in the liver and hydrolyses triglyceride and phospholipids. C-514T polymorphism in HL gene promoter was reported to associate with hepatic lipase activity and plasma lipid levels. We examined whether C-514T polymorphism affects glucose metabolism beyond its effect on plasma lipid levels in nondiabetic Japanese subjects. Gene frequencies of C/C homozygote, C/T heterozygote and T/T homozygote were 18, 51 and 31%, respectively. The allelic frequencies of C and T were 44 and 56%, respectively. T allele frequency was much higher than in Caucasian subjects. Moreover, -514T allele carriers had higher levels of triglyceride (P=0.027), fasting insulin (P=0.016) and HOMA-IR (P=0.033) than non-carriers. In contrast to some former studies, -514T allele affected triglyceride levels and insulin sensitivity. Taken together, HL gene might be one of the important susceptibility genes of type 2 diabetes and the high incidence of type 2 diabetes could be explained by high frequency of -514T allele in the Japanese population. Moreover, since HL and adiponectin showed an additive effect on insulin sensitivity, these genetic variations can be independently associated with insulin sensitivity.


Asunto(s)
Resistencia a la Insulina , Lipasa/genética , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas/genética , Triglicéridos/sangre , Adiponectina , Alelos , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Péptidos y Proteínas de Señalización Intercelular/genética , Japón , Masculino , Persona de Mediana Edad , Factores de Riesgo
9.
Gastric Cancer ; 7(2): 117-21, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15224199

RESUMEN

Postoperative hepatic lymphorrhea is a very rare complication after abdominal surgery. Hepatic lymphorrhea, not containing chyle, involves an internal lymph fistula between the lymphatic channels toward the cisterna chyli and the peritoneal cavity. Over the past 20 years, 17 cases have been reported in Japan. Here, we report a further case, of a patient with successfully treated intractable hepatic lymphorrhea following gastrectomy for early gastric cancer. We review 18 cases, including the present case, with respect to the management of postoperative lymphorrhea refractory to conventional medical treatment.


Asunto(s)
Gastrectomía/efectos adversos , Hígado/patología , Linfocele/diagnóstico , Neoplasias Gástricas/cirugía , Anciano , Ascitis/etiología , Ascitis/cirugía , Fístula/etiología , Fístula/cirugía , Humanos , Ligadura , Escisión del Ganglio Linfático , Linfocele/etiología , Linfocele/cirugía , Masculino , Picibanil/uso terapéutico , Complicaciones Posoperatorias , Recurrencia , Escleroterapia , Neoplasias Gástricas/tratamiento farmacológico , Factores de Tiempo
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