| Language：日本語 ／ English |
| 2018y vol.18 Issue 2 |
| preface |
| Learn from "But he has nothing on at all." |
Kazuaki Yoshimawa |
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| Original Articles |
| Study of risk factors contributing to early mortality after percutaneous
endoscopic gastrostomy |
Yusaku KAJIHARA |
Abstract:Objective: The aim of the present study is to investigate the
risk factors contributing to short-term mortality after percutaneous endoscopic
gastrostomy (PEG).
Methods: I performed a retrospective study of 466 patients who underwent PEG by the modified introducer method using a sheath dilator at Fuyoukai Murakami Hospital from August 1, 2011 to March 31, 2018. I calculated 30-day mortality (early mortality) after PEG. In addition, I used logistic regression models for identifying the relevant factors that contributed to early mortality and introduced five variables—age, serum albumin (Alb) level, hemoglobin (Hb) level, blood brain natriuretic peptide (BNP) level and serum C-reactive protein (CRP) level—into the model.
Results: Early mortality after PEG was 6.9% (32/466). Multivariate analysis revealed that the adjusted odds ratios for serum CRP level (≥6.70 mg/dL), Hb level (≤11.8 g/dL) and serum Alb level (≤3.1 g/dL) were 4.78 [95% confidence interval (CI), 2.10–10.9; p <0.001], 4.98 [95% CI, 1.42–17.5; p <0.05] and 2.88 [95% CI, 1.19–6.94; p <0.05], respectively.
Conclusion: High serum CRP level, low Hb level and low serum Alb level were independently related to higher early mortality after PEG.
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Keywords：percutaneous endoscopic gastrostomy (PEG), early mortality, C-reactive protein (CRP), hemoglobin, albumin
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| Short Communication |
Analysis of cancer treatment outcome as a work of hospital cancer registration concerning curative radiotherapy for localized prostate cancer and breast conservation therapy for breast cancer in Mutsu General Hospital.
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Hirofumi TSUBO
Yasushi MARIYA |
Abstract:We examined the outcomes, employing 3 types of survival rate,
of curative radiotherapy for localized prostate cancer and breast conservation
therapy for breast cancer from the survey data of hospital cancer registration.
As a result, the outcomes were comparable with those in the other well-known
or neighboring hospitals, suggesting to be within the level of national
standard. We would like to further investigate the treatment outcomes for
various cancers in future.
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Key words: survival, radiation therapy, breast conservation therapy, hospital cancer registration
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Efforts toward the team conference implementation
―For conference implementation with a doctor― |
Hitomi TANAKA |
The point: House nursing station in our hospital carries out aim management. The nursing divisional commander gives a presentation, named a practice briefing session in an end of the fiscal year, concerning the results of actions to resolve the problems of his/her own team. For the variorum treatment room, according to the judgement result of the hospital usability test, the enforcement of team conference was set as the self-aim of 2017 and the staffs struggled with the issue for one year. Hereby, the content of the presentation was briefly reported.
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Keyword: Aim management, hospital usability test, team conference
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Attempt to optimize the scanning time of CT angiography for lower limbs by test injection method at Mutsu General Hospital
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Shuhei FUKAYA
Kazutsugu KAWAMURA
Kazunori TAKEO
Kohei HAMADA
Keisuke JIN
Hirofumi YAMAGAMI
Yasushi MARIYA |
Abstract: At central department of radiology, Mutsu General Hospital, CT
angiography for arteries of lower limbs was performed using fixed time-of-shoot
method. However, there were a proportion of patients difficult to obtain
sufficient images at an appropriate timing according to blood flow status.
Therefore, since 2015, we have attempted to introduce the test injection
(TI) method to optimize intervals after intravenous injection of contrast
medium and followed CT scanning and decrease radiation exposure of the
patients. As a result, with an adequate volume of contrast medium, satisfactory
images have been obtained by the TI method.
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Key Words: CT angiography (CT-A),Test Injection method (TI method),Contrast Medium,Time-enhancement curve (TEC)
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| CASE REPORT |
| Care for a difficult to cure, markedly changing small intestinal fistula:
a case report |
Mika ICHINOWATARI
Miyuki KAWAHARA
Tadashi HASIZUME |
Abstract: Occurrence of postoperative gastrointestinal fistula is decreasing due to progress in nutritional management. When a fistula naturally occurs from progression of a malignant tumor, skin lesions from leaking of digestive juice and foul fecal odor becomes a problem. Due to shortened hospitalization and reduction in mortality of fistula patients, increasingly more patients are living at home. Fistula care for naturally occurring fistula is difficult for patients because the fistula is flat and difficult to see, and excrement frequently leaks. In our case, we needed to change the care protocol because a small difficult to heal intestinal fistula and frequently changed. The patient was able to continue living at home by cooperating with a visiting nurse.
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Key words: small intestinal fistula, pouching, multidisciplinary cooperation
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| PERFORMANCE REPORT |
Rehabilitation implementation status of the regional comprehensive care ward
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Naoko MURAKI
Mitsuaki SOHMA
Aiko NARITA |
Abstract: As the “Regional Comprehensive Care System” is being developed, the “Regional Comprehensive Care Ward” has been newly established to support regional comprehensive care for medical fee revisions in FY 2014. Functions of the regional comprehensive care ward include acceptance of patients from the acute phase beds (post-acute), acceptance of emergency patients from homes and institutions (sub-acute), and discharge support. Our hospital converted a part of the general wards int0 a regional comprehensive care ward which opened in November 2017. Rehabilitation deeply involved in home discharge support, and many patients continue to require rehabilitation after moving to the regional comprehensive care ward from general wards. In this survey, we investigated the rehabilitation status in the regional comprehensive care ward 6 months after opening. Approximately 30% of patients who moved from the general ward to the regional comprehensive care ward required rehabilitation. The average number of units to be calculated was 2.28, meeting the required 2 units of the rehabilitation criteria for community comprehensive care wards. The return-to-home rate was 66.2%, and approximately 30% of patients were transferred to other hospitals. In standards of regional comprehensive care ward facility, the return-to-home rate is set at 70% or more, but this rate for rehabilitation patients was not met. Regional comprehensive care ward has a major role in supporting home discharge, but our hospital has many problems to overcome before fully realizing its function. In the future, we would like to conduct more detailed surveys to clarify issues in regional comprehensive care wards and to examine how to engage as rehabilitation staff.
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Key words: Regional comprehensive care system，regional comprehensive care ward，return-to-home support，multi-occupation collaboration
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| Trends of echocardiography in Mutsu General Hospital |
Kazumi SOHMA |
Abstract: With the aging of the population in recent years, non-invasive examination and treatment are further required. Among them, the necessity of repeatable cardiac ultrasound examination is being increased more and more, and the number of examination increases year by year. The type of ultrasonic examination is not limited only to the heart but also extended to the fields of carotid artery and lower limb vein. The responsibility and importance of technicians, who are engaged in the ultrasonic examination, will increase more and more in the future.
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Key words: Echocardiography，Aging
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Approach for establishment of a regional comprehensive care ward
－A report half year after establishment－
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Seiko Sugiyama |
Abstract: With the declining birthrate and aging population, the role played by hospitals is changing, such as accommodating patients with chronic diseases and the setting of regional medical care due to an increase in elderly people living alone. Therefore, in addition to acute care that focuses on curing the disease, in order to continue living in a familiar area as much as possible while continuing to manage the disease, establishing a regional comprehensive system for care support is needed.
In January 2017 at Mutsu General Hospital, we launched a project to introduce community comprehensive care wards. We began operating the regional comprehensive care ward in November 2017, and here we report the progress of half year after introduction.
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Key words: Regional inclusive care ward, bed control, discharge support
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The third report of performance status of duty works, in fiscal 2017, according to the modalities employed in the center of radiology and radiotherapy in Mutsu General Hospital.
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Hirofumi YAMAGAMI
Mitsuaki KUBOTA
Daisuke SAKAMOTO
Takayuki YONENUMA
Kazutsugu KAWAMURA
Ryuji YONETA
Yasushi MARIYA |
Abstract: We investigated and reported the situation of duty-works at present according to the modalities, employed in the center of Radiology/Radiotherapy in Mutsu General Hospital. Considering the past two reports, we took thought of our role as staffs in the central hospital of Shimokita region through the improvement and optimization of the performance.
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Key Words: Research report, Activity report, Radiological diagnosis, Radiation therapy
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Report of FY-2017 Activity Results of the Department of Pharmacy, Mutsu General Hospital
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Koji YADA
Kiyoko FUJISAWA
Chizuru TAKAHASHI
Akio HAGINO |
Abstract: Our hospital is appointed as a base hospital of cancer medical treatment cooperation and carries a duty to provide medical care of high quality against cancer as a core institution of cancer treatment in Shimokita area. In the department of pharmacy, we, the pharmacists, have performed germfree preparation of cancer chemotherapy for in- and outpatients since October 2010 and have improved it continuously with pursuing higher safety. At this time, we gathered up the content of the activities of our department in the field of cancer chemotherapy and, focusing on them, reported the results of our duties in FY-2017.
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Key Word: Chemotherapy, Cancer chemotherapy, Prescription question
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Nutritional management Department of FY2017 earnings reports
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Ayumi SAWADA
Nozomi HACHINOHE
Natsuki HAMADA
Ikuko TAKANO
Nozomi NISHII
Hanako MATSUMOTO |
Abstract: There was no big change in the number of meals in the hospital diet medical expenses (I) in FY2017 compared to that of the fiscal year before. However, depending on the groups of age and disease, there was a change in the ratio of general diet and special treatment meal. Although the number of nutritional diet guidance cases tends to decrease, we are challenging to actively approach the continuation of guidance for patients who are newly requested
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Key words: Inpatient meal medical expenses (I)、Nutritional diet instruction
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Role of the Department of Clinical Engineering
at Mutsu General Hospital |
Yoshika ISHIKAWA
Kouko FUKUSHIMA
Yukie KUMAGAI
Saori SASAKI
Kazuaki ABE |
Abstract: We report the business statistics of the Department of Clinical Engineering of the 2017 fiscal year.
In the Department of Clinical Engineering, we mainly perform equipment management, cardiovascular work, and blood purification. In equipment management, inspection of pumps etc. transitioned without variation. There were increases in requests for inspection of respiratory rounds and of biometric information monitors. In cardiovascular services, pacemaker related work was on an upward trend. With regard to blood purification work, the number of cases increased with the increase in dialysis equipment, and treatment requests other than hemodialysis also tended to increase.
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Key words: Department of Clinical Engineering,equipment management, blood purification
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