学会誌 VOL.15 No.4 December 2022
原著論文
| ケミカルコーピングの認知度と医療用麻薬の不適切使用を疑った経験：アンケート調査 |
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| 藤本愛理、山中紗弥花、中原萌子、髙武嘉道、花田聖典、川俣洋生、橋本雅司 |
| ［要旨］ ケミカルコーピングは薬物依存の前段階と考えられているが，医療者における言葉の認知度は明らかとなっていない．本研究では，その認知度と医療用麻薬の不適切使用に関する経験の把握を目的として九州医療センターのスタッフを対象にアンケート調査を実施した．ケミカルコーピングの認知度は「意味を知っている」が 4.9%，「聞いたことはあるが意味を知らない」が 33.4%，「聞いたことがない」が 61.6% であった．患者の医療用麻薬の不適切使用を疑った経験のあるスタッフは 36.8% であった．また，スタッフの 87.5% が医療用麻薬について悩み・迷い・不安を感じたことがあり，97.1% が適正使用に関する知識やスキルが必要だと考え，90.2% が講習等を受けたいと回答した．ケミカルコーピングの知識を含む医療用麻薬の適正使用に関する教育の機会を設けることは，医療用麻薬の不適切な使用の回避につながり，医療用麻薬を安全に使用するうえで重要になると考える． |
| キーワード：医療用麻薬，ケミカルコーピング，医療用麻薬の適正使用 |
| A Questionnaire-Based Study on the “Dame. Zettai. (Never. Ever.)” Drug Abuse Prevention Campaign and the Medical Use of Narcotic Agents |
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| Tsutomu SUZUKI, Shinji HASEGAWA, Yuichi KORETAKA, Hirokazu MISHIMA, Hiroyuki TANAKA, and Hajime KAGAYA |
| Abstract: Pharmacotherapy for cancer pain is generally conducted in accordance with the World Health Organization recommendations, including the medical use of narcotics, such as morphine, for severe cancer pain. However, misunderstanding and preconception among the public has reportedly caused patients in Japan to be hesitant about the medical use of these drugs. The influence of the Dame. Zettai. (“Never. Ever.”) anti-drug abuse campaign (hereinafter Dame. Zettai. Campaign) may have contributed to this misunderstanding and prejudice. In this study, we examined the awareness and understanding of the Dame. Zettai. Campaign and the medical use of narcotics. We conducted an internet questionnaire survey targeting 3,000 men and women aged ≥ 20 years, excluding those assumed to have a specific understanding and knowledge of medical narcotics use. Regarding awareness of the medical use of narcotics, 74.5% (1,521 respondents) knew about the Dame. Zettai. Campaign and 62.2% (556 respondents) did not. Regarding the public’s impression of medical narcotics use, the proportions who answered “I think they are a last resort” and “they will gradually cease to be effective” tended to differ depending on whether or not the respondents knew about the Dame. Zettai. Campaign. This survey thus suggested that the Dame. Zettai. Campaign might affect the public’s perception and understanding of the medical use of narcotics. We believe that the results obtained from this study will provide important information to re-examine how to proceed with the future Dame. Zettai. Campaign. It is desired to verify whether there is a relationship between the level of awareness of the Dame. Zettai. Campaign and the level of understanding of medical narcotics in the future. |
| Key words: narcotic agents, drug abuse prevention, cancer pain, drug abuse prevention campaign, drug |
| Significance of Serum Essential Trace Element Measurementsin Terminal Cancer Patients ─Correlations between Serum Iron, Copper, Zinc and Cachexia-Related Proteins─ |
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| Tsutomu SUZUKI, Shinji HASEGAWA, Yuichi KORETAKA, Hirokazu MISHIMA, Hiroyuki TANAKA, and Hajime KAGAYA |
| Abstract: Background & Aims: Essential trace elements (ETEs) cannot be synthesized in vivo and must be ingested. Terminal cancer patients face concerns about the risk of trace element deficiency due to malnutrition. However, no studies appear to have comprehensively examined nutritional indicators or serum concentrations of trace elements among terminal cancer patients. We investigated correlations between the dynamics of serum ETEs and proteins related to cachexia. Methods: This study investigated 176 terminal cancer patients hospitalized between April 2018 and March 2019, after excluding patients already diagnosed with refractory cachexia at the time of admission and those who died within 10 days of admission. Cachexia-related proteins and serum trace elements were measured and correlations were examined. Results: Serum transthyretin (TTR) and albumin (Alb) values on admission were below standard values in all cases, and C-reactive protein (CRP) values were above the reference range in 81.9% of patients. No correla-tions were found between serum iron levels and serum TTR, Alb, and CRP levels. Significant correlations existed between serum zinc levels and serum TTR, Alb, and CRP levels. No correlations were found between serum copper levels and serum TTR, Alb, and CRP levels. Correlations between serum zinc levels and serum TTR and CRP levels were stronger in the 68 patients who received nutritional management for 1 month compared to correlations on admission. Conclusions: Patients with terminal cancer often show abnormalities in ETEs. Serum zinc levels correlated with cachexia-related proteins, suggesting that zinc may affect prognostic factors. |
| Key words: essential trace element, cachexia, terminal cancer, zinc, cachexia-related protein |
短 報
| カルシフィラキシスの難治性疼痛に対してブプレノルフィン坐剤が有効であった1例 |
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| 黒木あかね、安 武夫、城田幹生 |
| ［要旨］ カルシフィラキシスは，強い疼痛を伴う難治性皮膚潰瘍で知られている．今回，カルシフィラキシスによる処置時や透析時の疼痛に対しブプレノルフィン坐剤を使用した．使用開始後，処置時や透析時の体動や発声に改善があり，疼痛に対しブプレノルフィンが有効であると考え治療を継続した． |
| キーワード：カルシフィラキシス，ブプレノルフィン，難治性皮膚潰瘍 |