[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Purpose: To investigate the use and physical properties of test foods given during standard videofluoroscopic examination of swallowing (VF) in Japanese hospitals.
Methods: Twenty-five hospitals equipped for VF were surveyed regarding the type, composition, and preparation method of VF foods, and then classified into four groups based on the consistency of the foods used (liquid, thickened liquid/paste, jelly, and meal-like solid) for analysis.
Results: Hospitals varied in the number of VF foods used (total: 155; range, 2-12; mean, 6.2). Barium sulfate was used in 17 hospitals, and iodinated contrast media were used in 11 (3 used both). Liquid, thickened liquid/paste, jelly, and meal-like solid foods were used in 80%, 76%, 96%, and 72% of hospitals, respectively. Physically, liquid-food viscosities were similar across hospitals (range, 1-116 mPa-s), while those of thickened liquid/paste varied greatly (range, 79-1,984 mPa-s). This indicates that the physical properties described as “thick” or “thin” greatly varied depending on the hospital. Jelly had a hardness ranging between 640 and 48,000 N/m², an adhesion ≤ 900 J/m³, and an aggregation between 0.2 and 0.9. Meal-like solid foods were not analyzed, because it is difficult to obtain consistent data on them due to their heterogeneity.
Conclusion: VF food-types properties vary across hospitals and their physical properties of thickened liquid/paste except for liquid and jelly-food vary across hospitals.

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Objective: In the past, a conventional crushing method was used for the administration of tablets or capsules by tube in patients with dysphagia. However, this method has several problems, such as a loss of the drug amount and tube clogging. Recently, tube administration by a simple suspension method was developed to solve these problems in the conventional crushing method.
Methods: In the present study, we investigated to what extent the dosage amount is lost using the simple suspension method compared to crushing method, employing 5 drugs which are frequently administered by tube in Okayama University Hospital.
Results: Drug weights of the 5 agents decreased by 70 ～ 90% in the grinding and packaging processes because of drug adhesion to the mortar, packaging machine, and drug package paper. The suspension of all drugs using the simple suspension method was uniform, while only the suspension of Warfarin^® ground using the crushing method was shown to be showed inhomogeneous, which is expected to lead to a loss of drug. The drug content on assuming clinical a setting after tube passage was compared between the two methods. The recovery of warfarin^®, characterized as unstable using the crushing method, was nearly 50%, but loss was prevented by 80% with the use of bags of medicine. For the simple suspension method, the recovery of warfarin^® was almost 100%.
Conclusion: The results of this study suggest that the simple suspension method is particularly effective for the tube administration of drugs characterized as unstable.

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Objective: This study was performed to clarify the relationship between rhythms of daily living and nutritional status in elderly patients after medical treatment for acute diseases.
Methods: The study subjects were 21 elderly patients who transferred to the rehabilitation ward after medical treatment for acute diseases. Nutritional status was compared between the patients with and without rhythms of daily living disorder at the timing of transfer. In addition, the association between the change of rhythms of daily living and the change of nutritional status were examined in patients who had rhythms of daily living disorder at the transfer.
Results: Serum levels of total protein and albumin in patients with rhythms of daily living disorder were significantly lower than those without rhythms of daily living disorder. The nutritional statuses were improved in patients whose rhythms of daily living disorder disappeared. On the other hand, the nutritional statuses were not improved in patients whose rhythms of daily living disorder did not disappear.
Conclusion: The detail nutritional assessment and nutritional support are needed for the elderly patients who undergo medical treatment of acute diseases, since nutritional statuses were poor in elderly patients who had rhythms of daily living disorder after medical treatment for acute diseases.

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