Phenytoin (PHT), one of the antiepileptic drugs, exhibits nonlinear pharmacokinetics and its effective range is narrow (10~20 µg/mL). We examined the effect of prescription design by pharmacist on the administration of PHT, at the Trauma and Critical Care Center, Kyorin University Hospital. The number of cases which has been measured blood concentration in suitable administration time at before the support start and after the support began was 37 cases (71.2% of the measurement example) and 23 cases (74.2% of same). Among cases requiring multiple measurement, the patients who deviated from the effective range during treatment was before: 15 cases (75.0%) and after: 3 cases (33.3%) (p<0.05). Pharmacist prescription support was considered to maintain PHT concentration for cases requiring long-term administration (>13days) of PHT, which is frequently treated at a critical care centers such as status epilepticus, patients which other medicine is ineffective, and patients who continue to receive PHT from other hospitals.

Our objective was to predict the number of heat stroke patients from meteorological and Twitter data.

Materials and Methods: Using 2015-2017 data for Kanagawa and Osaka, we fitted a formula to predict the number of heat stroke patients from daily mean temperature and the number of tweets (Twitter data points) about heat stroke. Then, to verify the accuracy of the formula, we applied it to 2016-2017 data for Tokyo and 2015-2017 for Kanagawa and Osaka.

Results: The coefficient of correlation between the actual and predicted numbers of heat stroke patients in Tokyo was 0.9726, and prediction accuracy was improved by including number of tweets, even when applying the formula to another area.

Discussion and Conclusion: The number of heat stroke patients can be predicted in real time from daily mean temperature and Twitter data, which could allow protective measures to be taken.

We report that the Urasoe Public Health Center of Okinawa Prefecture Southern Health Center was constructed a support system for suicide attempts, in collaboration with Urasoe general hospital. This system started operation from 1 April 2016. The subject of investigation was considered as a case admitted to our hospital from 1 April 2016 to 31 March 2017 at medical record review. There were 59 attendants committed suicide to our hospital. There were 8 deaths. The desire of death was confirmed at 64.4%. Past suicide attempts was 40.7%. The public health nurse could actually intervene only two cases. Both cases had various problems such as money and family relations. Unfortunately there are still few cases that could be intervened. This system can be expected to be effective, because there is a report that fatal suicide rate is high immediately after hospitalization due to attempted suicide.

In recent years, various marathon-length road races large and small have been happening almost every week. Medical and first aid structures suitable for events on this scale have been requested, but the organizers have not taken on the policies that they should. This is why we have created policies that cover the medical and first aid structures these events need with the cooperation of doctors and fire departments, for use by organizers as references. We made these materials by consulting existing domestic and international manuals, getting the opinions of people experienced in running medical and first aid structures, and bringing together the knowledge of people who have observed marathons, and a survey of the literature on the topic. The policies we made set out concrete recommended numbers of first aid staff and stations, recommended equipment, as well as standards and specifications for the above.
Ensuring that adequate medical and first aid structures are in place for marathons is not only a matter for organizers, but also relies on the awareness of best practices on the part of fire departments and medical institutions. These policies also include a system for scoring medical and first aid structures, so would allow events across the country to be compared laterally, by adopting a unified set of standards.