RESUMO
During the COVID-19 pandemic, the incidence of eating disorders (ED) has increased not only in Japan but also worldwide. This online survey for pediatricians showed that caregivers tend to visit specific pediatric institutions or child psychiatry departments when children under junior high school age develop eating disorders. There are few pediatric institutions regarding treatment acceptance for children with ED. Of the 34 respondents, 16 (47.1%) answered that the number of visits for children with eating disorders had "stayed the same", one answered it had "decreased" and 17 (50.0%) answered it had "increased" or "increased very much". In addition, 28 of the 34 respondents (82.3%) experienced difficulties with psychotherapy for children with ED. For treating children with ED, pediatricians usually conducted physical examination and have some clinical burden. ED are increasing in the COVID-19 pandemic. Because children with severe ED need to be hospitalized, child and adolescent psychiatric wards are overcrowded and some children with other mental disorders can't be admitted.
RESUMO
The number of cancer patients and their families desiring home-based care has been increasing over the last few years. We reported a patient, a 40-year old female patient with advanced pancreatic cancer (T4N3M1, Stage IVb). Once we had switched from a systemic administration of opioid to an epidural administration via a subcutaneous reservoir for her extreme pain, she was given relief from her severe pain and was able to be discharged. Although against her wishes, she had to be taken back into hospital due to both an inappropriate management of the subcutaneous reservoir by the general practitioners and her spiritual (existential) pain. Public support systems are urgently needed to be established for patients who continue to receive a home-based care.