Kanno T.,University of Tokyo |
Hayano K.,Tokyo Metroplitan University |
Ishida C.,Showa University |
Kawahara K.,Tokyo Metroplitan University |
And 4 more authors.
10th International Conference on Probabilistic Safety Assessment and Management 2010, PSAM 2010
This paper proposes and examines a method to elicit cognitive competencies for disaster nursing based on the results of a content analysis of interview data. One aspect of the method focuses on cognitive process in terms of the transitions among the three primitive cognitive steps: "information (perception)", "decision", and "action". The other aspect uses a natural language processing technique and focuses on the targets of perception in disaster situations. This method was applied to the results of a content analysis of interviews with nurses who exhibited high performance in actual earthquake disasters. It was found that there were different cognitive patterns depending on the nursing tasks, but there were also some common characteristics found with respect to the objects of attention and concern among good performers. Cognitive competencies for the disaster nursing activities obtained in this study are summarized. Source
Kamoi K.,Ojiya General Hospital |
Kamoi K.,Niigata University
Clinical and Experimental Hypertension
Previous cross-sectional studies and 6-year longitudinal study have demonstrated that home blood pressure (HBP) measurements upon awakening have a stronger predictive power for death, micro-and macrovascular complications than clinic blood pressure (CBP) measurements in patients with type 2 diabetes (T2DM). This study investigated which of these measurements offers stronger predictive power for outcomes over 10 years. At baseline, 400 Japanese patients with T2DM were classified as having hypertension (HT) or normotension (NT) based on HBP and CBP. The mean survey duration was 95 months. Primary and secondary end-points were death and new or worsened micro-and macrovascular complications, respectively. Differences in outcomes for each end-point between HT and NT patients were analyzed using Kaplan-Meier survival curves and log-rank testing. Associated risk factors were assessed using Cox proportional hazards analysis. Based on HBP, death and micro-and macrovascular complications were significantly higher in patients with HT than with NT at baseline and end-point. Based on CBP, there were no significant differences in incidence of death, micro-or macrovascular complications between patients with HT and NT at baseline and end-point, although a significant difference in incidence of death was observed between the HT and NT groups at end-point. However, the significance was significantly lower in CBP than in HBP. One risk factor associated with micro-and macrovascular complications in patients with HBP was therapy for HT. This 10-year longitudinal study of patients with T2DM demonstrated that elevated HBP upon awakening is predictive of death, and micro-and macrovascular complications. © 2015 Informa Healthcare USA, Inc. Source
Imai N.,Ojiya General Hospital |
Imai N.,Niigata University |
Endo N.,Niigata University |
Hoshino T.,Ojiya General Hospital |
And 3 more authors.
Journal of Bone and Mineral Metabolism
Due to the increasing elderly population, the prevalence of osteoporotic hip fractures in Japanese patients continues to rise. It is well established that patients with either hip fracture or both symptomatic and asymptomatic morphometric vertebral compression fracture (VCF) have a poor health prognosis compared with the general population. The purpose of this study was to retrospectively investigate vertebral fracture rates among patients with hip fracture and their influence on mortality. We examined 182 cases of osteoporotic hip fracture in patients admitted to our institution between January 2009 and May 2011. The average age at the time of fracture was 85 years. Radiographs of the lumbar spine were obtained from all of the participants and the lateral spinal radiographs were examined for evidence of VCF. The patients were classified into two groups, those with VCF and those without. A VCF was identified in approximately 78 % of the patients. The mortality rate 1 year after the hip fracture was approximately 22 % and it was significantly higher in patients with VCF. Through multivariate statistics we found that VCF, post-operative complication, loss of ambulation after operation and medication for osteoporosis were statistically significant. In other words, VCF, post-operative complication and loss of ambulation were considered to be poor prognostic factors and medication for osteoporosis was likely to improve the prognosis. We concluded that the risk of mortality after hip fracture is significantly greater in patients who also have VCF compared to patients without VCF, and that medication for osteoporosis is likely to improve prognosis. © 2014, The Japanese Society for Bone and Mineral Research and Springer Japan. Source
Takeyoshi I.,Gunma University |
Makita F.,National Nishi Gunma Hospital |
Tanahashi Y.,Shibukawa General Hospital |
Iwazaki S.,Tatebayashi Kosei Hospital |
And 17 more authors.
Background: Paclitaxel and doxifluridine (5′-DFUR) have distinct mechanisms of action and toxicity profiles. This study evaluated the antitumor activity and toxicities of combination chemotherapy with these drugs in patients with advanced/recurrent gastric cancer (AGC). Patients and Methods: Patients with histologically confirmed AGC, which was either unresectable or metastatic, were included in this study. The treatment consisted of 80 mg/m2 paclitaxel given i.v. on days 1, 8, and 15 every 4 weeks, and 533 mg/m 2 doxifluridine given orally on days 1-5 every week. Results: One hundred and four patients were evaluated for toxicity and 93 patients were evaluated for a therapeutic response. The overall response rate was 33.3% (1st line: 41.7%, 2nd line: 25.0%), including a complete remission in two patients, a partial remission in 29, stable disease in 39, progressive disease in 17; the response was not evaluable in six patients. The median overall survival was 287 days. Commonly observed grade 3/4 adverse events were leukopenia (13.5%), anorexia (3.8%), fatigue (3.8%) and diarrhea (2.9%). Conclusion: Paclitaxel and doxifluridine combination chemotherapy is a well-tolerated and convenient treatment regimen that can be given on an outpatient basis with promising efficacy for AGC. Source
Takeyoshi I.,Gunma University |
Makita F.,Nishi Gunma National Hospital |
Iwazaki S.,Tatebayashi Kosei Hospital |
Ishikawa H.,Fujiyoshida Municipal Medical Center |
And 16 more authors.
Background: The efficacy of systemic chemotherapy for peritoneal dissemination of gastric cancer remains unclear. The efficacy of weekly paclitaxel in combination with doxifluridine (5′-DFUR) in gastric cancer patients with malignant ascites was evaluated. Patients and Methods: Patients with histologically confirmed gastric cancer with ascites were eligible. The treatment consisted of paclitaxel intravenously (i.v.) administered at 80 mg/m 2 on days 1, 8 and 15 every 4 weeks, and doxifluridine administered orally at 533 mg/m 2 on days 1-5 every week. The response rate for patients with ascites was determined based on the Japanese Classification of Gastric Carcinoma. Also, the concentration of paclitaxel in the ascites was measured. Results: Twenty-four patients were investigated. The response rate (RR) was 41.7%, including complete remission (CR) and partial remission (PR) in 4 and 6 patients, respectively. The concentration of paclitaxel in the ascites was maintained between 0.01 μM and 0.05 μM until 72 hours. The median overall survival (OS) was 215 days, and 1-year survival rate was 29.2%. No severe toxicity was noted. Conclusion: Weekly paclitaxel in combination with doxifluridine is effective for gastric cancer patients with malignant ascites with an acceptable toxicity profile. Source