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Volume 70, Issue 5
Displaying 1-13 of 13 articles from this issue
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ORIGINALS
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Satoru MATSUOKA, Akira SHOJI, Gen ABE, Yoshikazu TAMURA, Takashi SAITO2022 Volume 70 Issue 5 Pages 437-447
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSExercise training is reported to have beneficial effects on both lipid profile and exercise capacity in patients with coronary artery disease. In this retrospective study, we investigated the association between the effect of phase II cardiac rehabilitation (CR) on lipid profile and that on exercise capacity in patients with acute coronary syndrome (ACS). We analyzed 104 consecutive patients with ACS on statin therapy (age 62 ± 8 years, men 86) who received phase II CR after successful percutaneous coronary intervention (PCI). We examined lipid measurements and cardiopulmonary exercise test results before and after phase II CR. After 4 months of phase II CR, percentage of predicted aerobic threshold (%AT) based on age and gender significantly increased from 67 ± 11% to 76 ± 12% (p＜0.001), high-density lipoprotein cholesterol (HDL-C) significantly increased from 41.5 ± 11.8mg/dL to 51.4 ± 12.6mg/dL (p＜0.001), and ratio of lowdensity lipoprotein cholesterol to HDL-C (LDLC/HDLC) significantly decreased from 2.3 ± 0.8 to 1.8 ± 0.6 (p＜0.001). A positive correlation was found between change in HDLC and change in %AT (r = 0.463), as well as between percent change in HDLC and percent change in %AT (r = 0.485). A negative correlation was found between change in LDLC/HDLC ratio and change in %AT (r =－0.379), as well as between percent change in LDLC/HDLC ratio and percent change in %AT (r =－0.374). Multiple regression analysis showed that change in %AT was the only factor associated with both change in HDLC and change in LDLC/HDLC and that percent change of %AT was the only factor associated with both percent change in HDLC and percent change in LDLC/HDLC ratio. In conclusion, improvement of lipids profile was correlated with improvement of %AT in phase II CR for patients with ACS on statin therapy after successful PCI.View full abstractDownload PDF (846K) -
Tomoko OGINO, Emiko SHINOZAKI2022 Volume 70 Issue 5 Pages 448-459
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThe purpose of this study was to assess the effectiveness of photograph therapy in regulating autonomic fluctuations and autonomic balance in elderly adults with dementia. Eight weekly sessions of a 1-h program consisting of photo-taking, photo selection, album creation, and presentations were conducted with 10 elderly adults with mild to moderate Alzheimer's disease. Autonomic nerve balance (ANB) and largest Lyapunov exponent (LLE) data obtained from fingertip pulse wave measurements taken before, during, and after program sessions were analyzed (66 data points each). The program was also conducted with 5 healthy elderly adults to verify the effects of photograph therapy on measures of autonomic function (20 data points each). ANB results indicated tension in 40.3% of the elderly participants with dementia before sessions, but this percentage decreased to 27.3% during sessions, and the percentage with good balance increased from 20.9% to 36.4%. The percentage of participants with little fluctuation in LLE decreased from 53.3% before sessions to 42.4% during sessions, and the percentage with good balance increased from 37.9% to 53.0%. This effect was more pronounced in participants with dementia than in healthy participants. These results suggest that photograph therapy could regulate autonomic fluctuations and ANB.View full abstractDownload PDF (1257K)
RESEARCH REPORTS
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Yuka KUSUMOTO, Rika YATSUSHIRO2022 Volume 70 Issue 5 Pages 460-473
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThis study aimed to clarify the actual conditions and issues of support provided to nurses working in remote areas (“remote nurses”) at hub hospitals in remote areas in Japan. We mailed self-administered questionnaires to 294 hub hospital facilities in remote areas across Japan, and responses were obtained from 64 (21.8% recovery rate). These nurses in remote areas were provided support in the form of dispatch and training/consultation services at 19 of these 64 facilities (29.7%). A large majority affirmed that there was a social role (93.2%) and need (93.8%) for remote nurse support. Moreover, nearly one-third of the hospitals (30.2%) had no experience in dispatching nurses to rural areas but reported that they may do so in the future, indicating high recognition of the roles and necessity of remote nurse support. Issues in remote nursing support included nurses shortages at hub hospitals for remote areas, difficulties in building coordination and support systems, limited information and knowledge about remote healthcare, poor understanding of the roles of remote medicine centers, selection and management of nursing staff providing remote nursing support, and assistance in providing remote nursing support. Some departments took creative measures so that remote nurses would not have to leave their workplace for training or medical/nursing consultations. Expanding support for nurses in remote areas will require interventions by national and local governmental authorities to systematize both hospital staffing to better prepare for remote nurse dispatch and the support provided to remote areas. Furthermore, practical reports and fact-finding surveys should be conducted on remote nursing support, and information should be disseminated to all parties involved in rural and remote healthcare.View full abstractDownload PDF (917K) -
Manabu MAEDA2022 Volume 70 Issue 5 Pages 474-478
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThis study analyzed patients with metal allergy who underwent patch test (Sato Pharmaceutical Co., Ltd.) in the past 5 years. Seventy-five patients (male 27, female 48, mean age 55.7 ± 18.7 years) were divided into three groups: metal allergy only (metal only group; n = 22), metal allergy complicated by pustolosis palmaris et plantaris (PPP group; n = 13), and metal allergy complicated by lichen planus or other conditions such as prurigo and hand dermatitis (LP group; n = 7). The result showed that patch tests were most frequently positive for gold thiosulfate, nickel, cobalt, para-phenylenediamine, and carba mix, in that order. The most common positive allergen was gold, at more than 70% in all three groups, followed by cobalt in the metal only group, nickel & carba mix in the PPP group, and carba mix and paraphenylenediamine in the LP group. Gold allergy increased markedly over the 5-year study period.View full abstractDownload PDF (799K) -
Masatoshi SHIGETA, Takayuki KUGA, Yuka YANO, Takayuki KAWACHI2022 Volume 70 Issue 5 Pages 479-484
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSVenous thromboembolism (VTE) is a common complication in patients with cancer, particularly those with gastrointestinal cancers. In addition, patients with distant metastasis of gastrointestinal cancer often require palliative surgery. Here we report on the current status of VTE in patients with gastrointestinal cancers at our hospital, where we treated 20 patients with gastrointestinal cancers who developed VTE between January 2009 and December 2018. Nine patients had gastric cancer, 6 had colorectal cancer, 3 had biliary cancer, and 2 had pancreatic cancer. Fifteen of the 20 patients had distant metastasis as well. Median survival was 9 months, but VTE was not the direct cause of death in any patient. Although many of these patients had advanced cancer with distant metastasis, 16 still required gastrointestinal surgery. Our findings indicate that gastrointestinal surgeons need to be proficient in the diagnosis and treatment of VTE in patients with malignancy.View full abstractDownload PDF (686K) -
Norio WATANABE, Yukie FURUZAWA, Mariko SOUMIYA, Rika USAMI, Mayumi KOZ ...2022 Volume 70 Issue 5 Pages 485-497
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSA survey was conducted to determine the current status and issues of dysphagia care in hospitals and long-term care facilities in Gifu Prefecture. Responses were obtained from 14 hospitals, 13 welfare facilities for elderly adults requiring long-term care (WFs), and 13 geriatric health services facilities (GHSFs). Dysphagia teams were present at 12 hospitals, 4 WFs, and 8 GHSFs. The teams primarily consisted of general nurses (hospitals = 12, WFs = 4, GHSFs = 8; same order below), certified dysphagia nurses (11, 1, 0), nutritionists (11, 4, 7), speech-languagehearing therapists (11, 0, 5), physicians (7, 2, 4), and pharmacists (7, 0, 0). Facilities that employed certified dysphagia nurses conducted screening for dysphagia, but many hospitals and long-term care facilities did not review patients’ medications to identify medications that could cause dysphagia. In addition, many hospitals did not educate care workers about assisting with eating and swallowing. This demonstrates a need to improve dysphagia-related screening and educational systems for nurses and care workers at hospitals and long-term care facilities.View full abstractDownload PDF (1091K)
CASE REPORTS
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Makoto SATO2022 Volume 70 Issue 5 Pages 498-503
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSWe present 3 cases of ST-segment elevation myocardial infarction (STEMI) diagnosed at our hospital in which transfer to a distant facility for emergency percutaneous coronary intervention (PCI) was difficult. In Case 1, continuous adjustment of high-dose catecholamine was required due to cardiogenic shock. In Case 2, cardiopulmonary arrest due to ventricular arrhythmia occurred repeatedly during transportation. In Case 3, severe pulmonary edema and hypoxemia were present as complications and manual positive-pressure ventilation assistance was required. In all cases, long-distance transportation of 90 min or more was necessary, which increases the risk of death during transportation in serious cases such as these. To reduce the mortality rate of STEMI, it is important to understand difficulties in the initial response at local facilities where medical resources are scarce and to reinforce the medical care system of the entire region, including safe transfer to another hospital. It is necessary to urgently consider a medical cooperation system covering a wide medical area, including not only mutual cooperation with neighboring medical institutions and fire departments, but also the operation of doctor helicopters and doctor cars.View full abstractDownload PDF (3133K) -
Satoshi KOBAYASHI, Kenichi KOMAYA, Takehiro TAKAGI, Takashi MAEDA, Mas ...2022 Volume 70 Issue 5 Pages 504-509
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThe patient was an 80-year-old man who was diagnosed with cStage IIIB non-small cell lung cancer (NSCLC) and early gastric cancer. The advanced lung cancer was treated with chemotherapy while the gastric cancer was monitored. Immune checkpoint inhibitors were effective against the lung cancer for a long period, but new gastric cancer appeared and progressed to an advanced stage, necessitating total gastrectomy 5 years after the diagnosis of NSCLC. The patient is currently being treated with a molecular targeted agent for progression of the lung cancer after gastrectomy. In the future, the number of cases with multiple primary cancers will increase alongside aging of the population and advances in cancer treatment, and a system for tumor-agnostic treatment selection and medical treatment will be necessary.View full abstractDownload PDF (2372K) -
Manabu MAEDA, Satoshi SAKAMOTO2022 Volume 70 Issue 5 Pages 510-514
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSAn 87-year-old woman visited our hospital because of severe widespread purpura with swelling on the right arm. Two days earlier, she had used an electric vacuum cleaner for several hours in order to remove an insect infestation (march flies) in her house. The next day, the purpura expanded to the right chest. Internal medical examination revealed no abnormality except for high levels of myogenic enzymes (lactate dehydrogenase, 326U/L; creatine kinase, 401 IU/L). The electric vacuum cleaner was made in Japan and showed a vibration level of 60dB, which is half that of a chainsaw or lawnmower (120dB). The purpura may have been caused by long-term use of the vacuum cleaner given that the effective value of equivalent vibration acceleration exceeded the European guideline (2.5m/s2 for 8 hours per day).View full abstractDownload PDF (1341K) -
Yasushi KAWAHARADA2022 Volume 70 Issue 5 Pages 515-522
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSWe report a case of synchronous triple lung cancers with different pathological findings: carcinoma not otherwise specified, microinvasive adenocarcinoma, and adenocarcinoma in situ. The patient was a 71-year-old man who underwent computed tomography during follow-up for sigmoid colon cancer surgery. Ground-glass nodules (GGNs) were observed bilaterally in the lungs. After 7 years of follow-up, a cavitary lesion in the left lower lobe showed wall thickening and malignancy could not be ruled out. The size of nodule increased rapidly within 2 months and the left hilar lymph node also rapidly increased in size, leading to a diagnosis of cT2aN1M0, stage IIB lung carcinoma. Surgery was performed and revealed that the left hilar lymph node had invaded into the left main bronchus to the tracheal bifurcation and left main pulmonary artery. Therefore, left pneumonectomy was performed but complete resection was not possible. The pathological findings showed the left hilar tumor was carcinoma not otherwise specified, the tumor in the left lower lobe was microinvasive adenocarcinoma, and the GGN in the left upper lobe was adenocarcinoma in situ. Thus, the final diagnosis was synchronous triple lung cancers. In cases with imaging findings of multiple lung lesions, it is necessary to select the treatment considering the possibility of multiple primary lung cancers.View full abstractDownload PDF (4154K) -
Yoshitaka ENOMOTO, Toshiaki TAKAHASHI, Masaaki KUME2022 Volume 70 Issue 5 Pages 523-528
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThe patient was a man in his 80s. PCR test was performed after he developed a fever, and the result was positive for SARS-CoV-2 infection. On admission, CT showed ground-glass opacities and consolidation in both lung fields, leading to a diagnosis of COVID-19 pneumonia. The fever promptly resolved after starting treatment with dexamethasone 6.6 mg injection, but high fever returned the day after discontinuing dexamethasone. We considered bacterial pneumonia as a complication, but antibiotics were ineffective. We suspected cytokine storm and began steroid pulse therapy. The fever temporarily resolved but returned when the steroid dose was reduced. In the differential diagnosis, we considered opportunistic infections such as fungal infection and cytomegalovirus infection, pulmonary tuberculosis, and non-infectious lung diseases such as idiopathic organizing pneumonia. Examination and treatment were performed with these in mind. Finally, we diagnosed pulmonary tuberculosis and cytomegalovirus infection, and treatment was started for each. He was subsequently transferred to a treatment facility for patients with tuberculosis. Steroids are a key drug in the treatment of COVID-19, but they may reduce immune function and increase susceptibility to infection, so caution is required for various infectious diseases.View full abstractDownload PDF (1483K)
NURSING RESEARCH REPORTS
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Suzumi TAUE, Risa MOMOSE, Tadahiro KARASAWA, Ayumi MIYASAKA, Toshikazu ...2022 Volume 70 Issue 5 Pages 529-534
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSHospital A has 12 dedicated beds for patients with intractable neurological diseases, which are chronic conditions that increase dependence on medical care as they progress. Disease progression also varies by disease and by patient. Patients and their family become more anxious about discharge when they think about how much the patient’s condition has changed since admission. Caregivers must acquire specialized skills due to the patient’s increased dependence on medical care and the increased number of care tasks, and it takes time to master those skills. Discharge is associated with many financial, physical, and mental stressors, and in some cases discharge coordination is difficult and the timing for discharge is missed. We sought to investigate how to provide more efficient discharge support and conducted a case study of 3 patients with intractable neurological diseases. Here we discuss our findings and our creation of a discharge support manual that clarifies when to start discharge coordination, necessary preparations, and topics for counseling patients and caregivers.View full abstractDownload PDF (989K) -
Risa HAMANO, Megumi NAGAO, Takiko MATSUNO, Ritsuko KUBOE, Yasuyo WATAN ...2022 Volume 70 Issue 5 Pages 535-542
Published: 2022
Released on J-STAGE: February 20, 2022
JOURNAL FREE ACCESSThe purpose of this study was to clarify difficulties and countermeasures in nursing practice for foreign patients with COVID-19 who were non-English native speakers. A questionnaire was collected from 16 nurses in a COVID-19 ward. They cared for 13 non-English-speaking foreign patients from admission to discharge in the ward between May 2021 and June 2021. All nurses reported difficulties in communication related to collecting information from patients and explaining hospital care. For example, they could have simple conversations using a two-way translation device (POKETALK®) but could not understand detailed symptoms or complaints without an interpreter. Not much meaning could be inferred from a patient’s response of “OK”. The nurses reported that it was difficult to explain details of treatments, Japanese customs, and hospital rules. With the help of interpreters, they made hospital manuals and question cards in the patients’ native languages. In nursing care for foreign patients with COVID-19, it was helpful to provide explanations of Japanese customs and hospital rules before admission and to prepare hospital manuals and question cards in patients’ native languages.View full abstractDownload PDF (1156K)
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