北関東医学
Online ISSN : 1881-1191
Print ISSN : 1343-2826
ISSN-L : 1343-2826
最新号
選択された号の論文の9件中1~9を表示しています
原著
  • Odonchimeg Purev, Manduul Enkhjargal, Shota Ogawa, Tugsjargal Purevsuk ...
    2021 年 71 巻 4 号 p. 269-274
    発行日: 2021/11/01
    公開日: 2021/12/03
    ジャーナル フリー

    Objective: To investigate the association between the practice of radiation safety principles (PRSP) and participation in radiation safety refresher courses among Mongolian radiology professionals.

    Methods: This cross-sectional questionnaire-based study was conducted in Ulaanbaatar, Mongolia. The questionnaire was distributed to 250 participants, and 156 questionnaires were analyzed.

    Results: Only 59.6% of radiologists and 59.8% of technicians used lead aprons regularly. Less than half of the professionals tried to minimize the time of the procedure (28.8% and 28.3%) and to distance themselves from the X-ray source (42.9% and 37.0%). The professionals who participated in radiation safety refresher courses had practiced the safety principles better than those who had not (p=0.028).

    Conclusion: In Mongolia, many radiology professionals did not practice proper radiation protection, but participation in radiation safety refresher courses was effective. Besides the importance of personal protective equipment supplies, further education and training for radiation safety for the professionals are required.

  • Lukman Hilfi, Nur Atik, Ardini Saptaningsih Raksanagara, Deni Kurniadi ...
    2021 年 71 巻 4 号 p. 275-288
    発行日: 2021/11/01
    公開日: 2021/12/03
    ジャーナル フリー

    Background & Aims: This study evaluated the construct validity of the Indonesian version of WHODAS 2.0 among persons with physical impairment.

    Methods: WHODAS 2.0 was self-administered to 212 participants with physical impairment in Bandung, Indonesia. The Rasch model was used to analyse the instrument’s construct validity.

    Results: Data of 212 participants were analysed. The average outfit mean-square (MnSq) of the 36-item and 32-item versions of WHODAS 2.0 satisfied the Rasch model expectations (0.99±0.28 vs 0.99±0.24). Item D2.5 ‘walking a long distance such as a kilometre’ and item D4.5 ‘sexual activity’ were identified as misfitting items in both versions (infit or outfit MnSq >1.4). The variance explained by measures of the 32-item version was 56.7%, and the 36-item version was 49.0%. Both versions’ reliability and separation index were excellent, with Cronbach’s alpha >0.90 and a separation index >2. The response category function and targeting did not fully satisfy the Rasch model expectations. A strong correlation between both versions of WHODAS 2.0 and WHOQOL BREF (r>0.60) established the convergent validity.

    Conclusions: The Indonesian version of the 32-item version of WHODAS 2.0 has acceptable construct validity in a physical impairment sample in Bandung, Indonesia.

  • Tomohiro Yazawa, Hitoshi Igai, Fumi Ohsawa, Ryohei Yoshikawa, Mitsuhir ...
    2021 年 71 巻 4 号 p. 289-292
    発行日: 2021/11/01
    公開日: 2021/12/03
    ジャーナル フリー

    Background & Aims: Spontaneous hemopneumothorax (SHP) is a rare condition that can result in shock due to extensive bleeding. However, the optimal timing of surgery remains controversial.

    Methods: Twenty-six patients who underwent surgery for SHP between July 1999 and December 2017 at our institution were retrospectively investigated.

    Results: Nineteen patients underwent emergent surgery (ES) and 7 underwent sub-emergent surgery (sub-ES). The ES group exhibited significantly higher drainage volume before surgery compared to the sub-ES group (blood loss; 512 ml vs. 258 ml, p=0.019), and higher total hemorrhage volume (1,056 ml vs. 458 ml, p=0.022). One sub-ES group patient, whose preoperative blood loss measured 150 ml, went into shock prior to surgery. His chest roentgenograms did not indicate significant hemorrhage in the thorax; however, his total blood loss measured 1,100 ml.

    Conclusions: The optimal timing of surgical intervention for SHP may depend on the extent of preoperative blood loss. However, preoperative drainage volume is not an accurate indicator of total blood loss, and chest radiographic findings are not reliable in some cases. Therefore, patients with SHP must be carefully monitored, and surgical treatment should proceed smoothly from conservative management as necessary.

  • 柴田 全利, 割崎 友莉恵, 金 始映, 佐藤 泰然, 牧野 孝俊, 十枝 はるか, 李 範爽
    2021 年 71 巻 4 号 p. 293-300
    発行日: 2021/11/01
    公開日: 2021/12/03
    ジャーナル フリー

    目 的:本研究の目的は職業的価値観が多職種連携態度形成に及ぼす影響を調べることであった.

    方 法:医療・介護職員151名を対象とした.職業的価値観を表すキャリア・アンカーカテゴリー得点と基本属性を独立変数とし,the modified Attitudes Towards Health Care Teams Scaleの各因子(“ケアの質”,“チーム効率”,“患者中心医療”)を従属変数とした重回帰分析を行った.

    結 果:“ケアの質”では,「純粋挑戦」と「生活様式」の志向が高いほど多職種連携に肯定的な態度であった.“チーム効率”では,「保障・安定」の志向が低く,「奉仕・社会貢献」の志向が高いほど肯定的な態度を示していた.“患者中心医療”では,「奉仕・社会貢献」の志向が高く,「保障・安定」の志向が低いほど肯定的な態度であった.

    考 察:複数側面の職業的価値観が多職種連携態度形成に影響することが明らかになった.

症例報告
  • 高橋 克昌
    2012 年 71 巻 4 号 p. 301-305
    発行日: 2012/11/01
    公開日: 2021/12/03
    ジャーナル フリー

     結核性頸部リンパ節炎の在留外国人,2症例を経験した.喀痰中に排菌はなく,画像検査と病理検査ではリンパ節結核に特徴的な所見が得られたが,リンパ節からの結核菌培養は困難で,血清学的検査とPCR検査を加えて総合的に診断した.日本人の結核発症者は,年々減少傾向にあるが,在留外国人の発症が増加傾向にある.現在,約38万人もの若い外国人が,技能実習生として日本で就労し,その多くは結核蔓延国出身の20歳代である.本来,結核性頸部リンパ節炎は,結核の発症形式としては稀であるが,若い在留外国人では多く認める傾向にあった.

  • 村田 美幸, 津田 泰利, 茂原 淳, 小谷野 哲也, 高橋 徹, 内山 俊正
    2021 年 71 巻 4 号 p. 307-310
    発行日: 2021/11/01
    公開日: 2021/12/03
    ジャーナル フリー

     症例は85歳女性.突然の胸背部痛を主訴に救急搬送され,解離性大動脈瘤と診断し,保存的加療を行った.入院直後に内頚静脈から中心静脈カテーテル(central venous catheter: CVC)を挿入した際に,ヘパリン加生理食塩水(ヘパリン生食)をルート内にフラッシュした.第5病日に再解離したため,緊急上行大動脈置換術を行った.ところが,術後3日目に左片麻痺が出現し,CT検査で広範脳梗塞を認めた.術後4日目には,血小板が顕著に減少し,ヘパリン起因性血小板減少症(heparin-induced thrombocytopenia: HIT)を疑った.精密検査でHITと診断し,アルガトロバンの投与を開始し,新しい塞栓は認めなかった.第49病日,リハビリ病院へ転院した.ヘパリン暴露から血小板減少までの期間を考えると,CVC挿入によるヘパリンフラッシュがHITの契機となったと考えられた.

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