[in Japanese]

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Background: Conservative (non-operative) management of acute appendicitis is becoming more accepted in routine clinical practice. However, conservative management is unable to treat all cases of acute appendicitis. On the other hand, operative management does not avoid negative, or unnecessary, appendectomy. In this study, we evaluated objective examination methods that would help clinicians to decide correctly conservative or operative management. Methods: This study was a single-center retrospective analysis of a Japanese medical insurance database. Data for 124 patients with acute appendicitis were retrieved and analyzed. Objective examinations included age, sex, computed tomography (CT), medical history, and blood laboratory data. Logistic regression analysis was used to identify factors associated with successful conservative management and negative appendectomy. Results: History of successful conservative management, negative finding of an enlarged appendix on CT images, and the absence of fecal stones in the appendix on CT images were significantly associated with successful conservative management (p=0.018, 0.006, and 0.044, respectively). Also a negative finding of enlarged appendix on CT images and low neutrophil sequestration were significantly associated with negative appendectomy (p<0.001 and 0.007, respectively). Conclusions: The negative finding of enlarged appendix on CT images was an important predictor for accurate selection of conservative and operative management of acute appendicitis.

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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: This study was carried out to obtain fundamental data required for the development of a career support system for nurses working in the critical care field. Its aim was to explore how the individual background and/or the interest in higher qualifications such as certified nurse and nurse specialist influenced the career maturity of such nurses. Method: Nurses who worked at emergency care centers or intensive care units of a particular city in Japan were asked to fill in a questionnaire form containing questions on basic attributes and interest in certified nurse and/or nurse specialist qualifications, as well as an assessment tool called the Occupational Career Maturity Scale (OCMS). The forms were left with the subjects for collection at a later date. Results: A positive correlation was found between the OCMS score and such factors as the age and the number of years in nursing generally and also in critical care nursing.  Male nurses, those having children, and those who were interested in certified nurse and/or nurse specialist qualifications had significantly higher OCMS scores than female nurses, those not having children and those who were not interested in the said qualifications. Conclusion: This study suggested that the career support system for critical care nurses should meet the changing needs at each stage of their life and career cycle and encourage them to enhance career maturity by pursuing the possibilities in specialist fields and building a clear vision for career development.

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