An Official Journal of the Japan Primary Care Association
Online ISSN : 2187-2791
Print ISSN : 2185-2928
ISSN-L : 2185-2928
Current issue
Displaying 1-7 of 7 articles from this issue
  • Aki Shibata, Masumi Takei, Asuka Suzuki, Kenzo Takahashi
    2024 Volume 47 Issue 1 Pages 3-11
    Published: March 20, 2024
    Released on J-STAGE: March 27, 2024
    JOURNAL FREE ACCESS

    Introduction: This study aimed to identify issues and concerns involved in a community-based activity and to identify requirements for supporting its continuation. Methods: Between September and November 2021, interviews were conducted with 12 volunteer residents who manage a community-based activity. Deductive content analysis was used to analyze the data. Yrjö Engeström's activity system model was used as the analytical framework. Results: Within the components of the activity system, the following "contradictions" were identified: supporters were anxious to continue their activities, the number of new participants in the community-based activity was not increasing, and human relationship difficulties constituted a regional characteristic. Among the components, the following "contradictions" were identified: many older adults were unable to participate in the community-based activity because of age- or health-related reasons, many older adults worked, and there were various other activities that did not result in subsequent participation in the community-based activity. Conclusion: The model also identified the need to consider visualization of the benefits of the community-based activity, comprehensive publicity activities involving residents, creating a system that allows people of all health levels to participate, and ongoing support for health promotion for the younger generation with anticipation of old age.

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  • Takamasa Osaki, Shusaku Tomita, Takahiro Harada, Shoko Matsumoto, Hiro ...
    2024 Volume 47 Issue 1 Pages 12-16
    Published: March 20, 2024
    Released on J-STAGE: March 27, 2024
    JOURNAL FREE ACCESS

    The patient was an 80-year-old woman with type 2 diabetes mellitus taking ipragliflozin. She underwent a colonoscopy one week prior to admission. After the colonoscopy, she felt exhausted and lost her appetite. On the day of admission, she was admitted to the emergency department because of abdominal pain and repeated vomiting. Physical examination and chest and abdominal CT were performed; however, no cause was identified for the abdominal pain or vomiting. Blood gas analysis showed high anion gap metabolic acidosis. Serum ketones were elevated to 6,045/μL and plasma glucose concentration was 182 mg/dL. We diagnosed ipragliflozin-induced euglycemic diabetic ketoacidosis (euDKA) and discontinued the drug. Ketoacidosis improved with administration of intravenous fluids and insulin injections. Her abdominal pain and vomiting improved. It is important to recognise that patients taking SGLT2 inhibitors may develop euDKA, as in this case, due to fasting after colonoscopy or reduced food intake after the procedure, and to discontinue SGLT2 inhibitors at least 2 days before the procedure.

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