Journal of UOEH最新文献

Before the outbreak of COVID-19, "Clinical Practice in Adult Nursing (Chronic Care)", a professional course to acquire basic nursing practice skills for the care of adult patients with chronic diseases, was conducted on site in the wards of internal medicine, outpatient departments, and the admissions support office for a total of three weeks. Due to the spread of the COVID-19 epidemic, however, clinical practice was carried out online from May 2020, and was resumed on site at our university hospital in October 2020. A restriction was placed on the length of time spent at the hospital for on-site training, referring to the training standards based on our university's new coronavirus response manual, and a training program was developed for hospital ward training, consisting mainly of shadowing practice performed without speaking or coming into contact with patients. In principle, two students were assigned to one patient: one in the morning and the other in the afternoon. In addition, for practicing the acquisition of patient information through conversation and the provision of nursing assistance, the perspectives used in the process of shadowing were clearly defined so that students could maintain active attitudes in clinical practice, and support was provided so that students could have the experience of engaging with patients, using nurses as mediators. In the results, the students evaluated the contents of the prepared assistance based on their own nursing plan in reference to the practice of the nurse as a mediator, and compared that with the assistance practiced by the nurse based on clinical judgment, which contributed to acquiring practical learning supported by the grounds for clinical judgment. However, the students could not experience the process of building supportive relationships and the implementation of nursing skills, which remained an issue.

We investigated the probability of measuring the odor of thirdhand smoke using four odor-measuring monitors and three gas detector tubes. We measured the changes in tobacco odor on paper towels and cloth products over time. The results of the measurements were plotted against time to obtain an exponential approximation curve. The coefficient of x and the R² values were calculated from this curve. The odor indicated by four types of odor-measuring monitors and three types of gas detector tubes decreased exponentially over time. The curves obtained from all measuring devices had coefficients of e^x between -0.001 and -0.021, and R² values of >0.8. The reproducibility of measuring relative odor levels through all measuring devices was high, suggesting a good capability of measuring thirdhand smoke odor. Two different odor-level standard gases can be used for the calibration of the regression curve for each monitor.

Pesticides are essentially toxic to living things and are used openly, so it is necessary to monitor them to prevent their adverse effects. We have studied farmers'exposure to pesticides during soil fumigation operations with chloropicrin, and have noted a danger to the farmers in the form of dyspnea. We examined accidents/symptoms of residents from chloropicrin reported by the Ministry of Agriculture, Forestry, and Fishery from 2010 to 2019. Eighty percent of the cause of these manifestations was the failure to cover fumigated soil with plastic film. Symptoms shown by residents included eye pain (91%), sore throat (35%), and headache (14%). The most common film used for covering fumigated soil in Japan is polyethylene. The agricultural technology centers in Japan have studied the use of gas barrier films, and found it possible to decrease the amount of chloropicrin used to 1/3, and leakage into the atmosphere to less than 1/10. This technology has become popular in the production of sweet potatoes in Tokushima Prefecture. Soil disinfection by solar heat has also been studied in Japan. These studies have shown positive advancements in the fertilization of soil and in the control of microbes. Chloropicrin has caused occupational exposure to farmers and environmental exposure to local residents. It is advisable that the technologies mentioned above become common practice.

We report a bilateral medial medullary infarction in which diffusion-weighted images revealed a unique configuration: a heart appearance sign. If it is early diagnosed, it might predict a poor outcome. An 85-year-old man developed dysarthria and numbness in his four limbs and was transferred to our hospital. Brain MR diffusion-weighted images revealed a high-intensity lesion in the bilateral medial medulla oblongata -- a heart appearance sign -- and we diagnosed a bilateral medial medullary infarction. Although his symptom changed aggressively for the worse, it finally changed for the better without bulbar paralysis, and he was transferred to another hospital for rehabilitation. When the medial medulla oblongata is supplied by the unilateral control of the anterior spinal artery, its occlusion can cause a bilateral medial medullary infarction.

The Japan "Ordinance on Safety and Health of Work under High Pressure", which is the law regulating health conditions for workers under high pressure environments, was amended in 2014. The revised regulations have highlighted other difficulties and new problems, but they have not yet written an appropriate amendment based on the aspect of occupational and environmental health. Health management for occupational divers and caisson workers in accordance with the new regulations has not determined the best approach to reducing related disorders and will cause other legal problems. This paper presents some issues in the new regulations for hyperbaric workers, which directly or indirectly involve occupational health physicians. Health checkups and work limitations should be done in consideration of the occupational characteristics of the undersea and hyperbaric environment. Regular examinations using specific studies are useful to diagnose the early stages of chronic conditions for workers, and are also useful for determining the hiring suitability for hyperbaric workers. Work limitations should be decided by the conditions that induce serious accidents or disorders that result from exposure to hyperbaric environments, and depend on the obstacles for work due to sequelae of decompression sickness. The new regulations need to be properly revised, based on scientific evidence, to include health management for workers in undersea and hyperbaric environments.

Pancreatic neuroendocrine carcinoma (NEC) as classified in the World Health Organization (WHO) 2010 was reclassified in the WHO 2017 as either neuroendocrine tumor (NET) G3 or NEC. An accurate diagnosis based on the WHO 2017 classification is important in order treating this disease appropriately. We report a case diagnosed as NET G3 that responded remarkably well to treatment with streptozocin. The patient would likely not have received the streptozocin treatment if she had been diagnosed with NEC. The WHO 2017 classification is reasonable for the treatment of advanced pancreatic neuroendocrine neoplasms.

Little is known about the factors related to return to work (RTW) in patients with peri-operative lung cancer (LC). This study aimed to investigate whether pre-operative physical performance is associated with early RTW in patients with peri-operative LC. A total of 59 patients who wished to resume work after lung resection surgery were included and were divided into three groups: early RTW (within 14 days after discharge), delayed RTW (within 15-90 days), and non-RTW (failure of RTW within 90 days). The early RTW group had significantly lower scores on the modified Medical Research Council dyspnea scale (mMRC) and significantly higher scores on the Euro Quality of Life 5-Dimension 3-Level (EQ-5D-3L) than the non-RTW group. Multivariate logistic regression analysis showed that EQ-5D-3L scores were significantly associated with early RTW, and mMRC scores and knee extensor strength tended to be associated with early RTW. Better pre-operative quality of life, mild dyspnea, and greater lower limb muscle strength tended to be associated with early RTW in patients with peri-operative LC.

A 60-year-old female had a subcutaneous mass in the B region of the left breast. A needle aspiration cytologic examination revealed class IV, and she was referred to our surgical department for examination and treatment. She underwent an ultrasound echography on bilateral the mammary glands and axillary lymph nodes. Erythematous papules and plaques were revealed on her left breast, left axilla, and in the center of the chest area. The patient was referred to our dermatology department for evaluation of her skin eruption. Histopathological examination revealed the infiltration of lymphocytes and eosinophils in the perivascular of the upper dermis with spongiosis and liquid degeneration in the epidermis. A patch testing showed a positive reaction to ultrasonography gel. Based on the clinical course and examinations, we diagnosed her skin eruption as contact dermatitis due to ultrasonography gel. Her skin eruption improved rapidly by topical application of betamethasone butyrate propionate ointment. Recurrence of her skin eruption could be avoided by the removal of the gel after the ultrasonography examination. Our case report demonstrated to us that contact dermatitis could be prevented by promptly wiping off the ultrasonography gel from the skin after the examination.