To investigate whether treatment comprised of Helicobacter pylori eradication followed by the administration of a proton pump inhibitor (PPI) alone and a dual treatment with a PPI plus a prokinetic agent helps relieve symptoms, we treated 26 patients with H. pylori infection and dyspepsia with the sequential treatment and assessed their symptoms. Scores for gastroesophageal reflux disease (GERD) and dyspepsia in a modified F-scale were significantly improved after the eradication of H. pylori, and symptoms were completely relieved in 13 patients. The remaining 13 patients received 4-week treatment with the PPI rabeprazole, and their GERD scores significantly improved after the treatment. The symptoms of five patients completely disappeared ; the other eight patients required dual treatment with a PPI plus the prokinetic acotiamide. Early satiety tended to be relieved after the dual treatment, but the improvement was not significant. Thus, in patients with dyspepsia and an H. pylori infection, the H. pylori should be eradicated first. The administration of a PPI is useful in patients with GERD symptoms, and a PPI+ acotiamide may be beneficial for residual symptoms of early satiety.

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 To clarify the scenario regarding the emergency medical treatment of patients undergoing otolaryngology in southeastern Okayama Prefecture in Japan, we evaluated the conditions in three hospitals that mainly provide emergency medical treatment to patients undergoing otorhinolaryngology at night or on holidays. The data (age, sex, type of disease, and address) of patients who visited Japanese Red Cross Okayama Hospital, Kawasaki Medical School General Medical Center, and Okayama Medical Center in 2018 were collected and compared. All three hospitals reported many cases of tonsillar abscess and nasal bleeding. In the study population, the number of patients aged ≤10 and 10-20 years were the lowest and highest, respectively. Patients residing in southern Okayama City and Tamano City tended to visit Japanese Red Cross Okayama Hospital or Kawasaki Medical School General Medical Center. Patients residing in northeastern Okayama Prefecture and northern Okayama City tended to visit Okayama Medical Center. A ceiling for the senior physicians’ capacity will be introduced in April 2020, and thus the number of otolaryngology-related treatments performed in Okayama Prefecture is expected to decrease. The otolaryngologyrelated emergency medical treatment in southeastern Okayama Prefecture may collapse. Emergency medical care systems must therefore be considered in the future.

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