当科における壊死性軟部組織感染症の臨床的・細菌学的検討

皮膚科学皮膚科学皮膚科学皮膚科学皮膚科学皮膚科学皮膚科

A case ofraptured abdomma1 aortic aneurysms

当院では手術室で死亡した, いわゆるtable deathは記録上2000年4月以来発生していなかった。今回, 2013年10月に腹部大動脈瘤の破裂により手術室にて死亡した症例を経験したので報告する

The summertime variation in Dissolved Inorganic Carbon concentration off Lutzow-Holm Bay

第１回極域科学シンポジウム「極域大気圏を通して探る地球規模環境変動」ポスター発

Temporal variation of dissolved carbonates in the summer of Antarctic seasonal sea ice zone

第１回極域科学シンポジウム「極域大気圏を通して探る地球規模環境変動」12月1日（水） 国立極地研究所 ２階大会議

非代償性肝硬変患者に対してリファキシミンと複数の瀉下薬使用により肝性脳症の回避を試みた一例～薬剤師による継続的なフィジカルアセスメントを通した排便コントロール～

Hepatic encephalopathy is often seen in patients with chronic liver disease. It is prognosis after onset is poor, and it is associated with significant mortality. In addition, it has a strong relationship with constipation, and,defecation management is important. Currently, the European Association for the Study of Liver and American Association for Study of Liver Diseases guidelines for the treatment of chronic liver disease hepatic encephalopathy recommend two to three defecations per day. However, frequent defecation is a burden on patients. in Japan, rifaximin, a non-absorbable antibacterial drug, was recently launched. As a result, the treatment of hepatic encephalopathy, which mainly involves lactulose, has been reviewed. in this case, the effect of combined use of rifaximin and a laxative against hepatic encephalopathy ware examined by evaluating intestinal peristalsis using astethoscope. This treatment prevented hepatic encephalopathy in the current case, despite the patient only defecating once a day. This approach was considered to be effective because the combined use of rifaximin suppressed the increase in the patient s blood ammonia concentration. In addition, the continuous recording of the patient s intestinal peristaltic sound confirmed that the risk of constipation had not increase although there had been no loss of intestinal peristaltic movement. These results suggest that the defecation management based on physical examinations conducted by pharmacist might be useful for assessing the risk of complications and quality of life issues in patient with chronic liver disease