Mite antigen and allergen contents of house dust samples.

The house dust mite (Dermatophagoides pteronyssinus) antigen and allergen contents were measured by enzyme-linked immunosorbent assay (ELISA) with enzyme-labelled anti-human IgE and anti-mite rabbit IgG antibodies. Antigen content was high in dust samples from homes of patients with allergy but not in samples from homes of patients with Kawasaki disease or of normal control subjects. Allergen content was high in dust samples from homes of Kawasaki disease patients. However, the values overlapped, and we considered these differences to be of little ecological significance, although the assay method itself is useful.</p

Safety of Silk-elastin Sponges in Patients with Chronic Skin Ulcers: A Phase I/II, Single-center, Open-label, Single-arm Clinical Trial

Background: Although traditional wound dressings such as collagen scaffolds promote granulation tissue formation, the efficacy of these dressings in chronic wounds is limited because of high susceptibility to bacterial growth. Biomaterials that can be applied to chronic wounds should have an anti-bacterial function. We previously reported that administering a silk-elastin solution that forms moisturizing hydrogels to wound surfaces of diabetic mice reduced bacterial growth and promoted granulation tissue formation compared with control or carboxymethyl cellulose hydrogels. We hypothesized that silk-elastin promotes wound healing in human chronic wounds by suppressing bacterial growth. Methods: An open-label, clinical case series was conducted with a prospective, single-arm design at Kyoto University Hospital in Kyoto, Japan. In this study, 6 patients with chronic skin ulcers of any origin (2 < ulcer area (cm2) < 25) on their lower extremities were included; patients with critical ischemia were excluded. Silk-elastin sponges were applied and covered with a polyurethane film without changing the dressing for 14 days. Inflammation triggered treatment discontinuation due to fear of infection. The primary study endpoint was adverse events, including inflammation and infection. Results: Poor hydrogel formation, possibly due to continuous exudation, was observed. No serious adverse events were noted. Two patients discontinued treatment on day 6 and day 7, respectively, due to inflammation, but they were not infected. The other 4 patients completed the 14-day silk-elastin sponge treatment without infection. Conclusion: Silk-elastin sponge is safe for chronic skin ulcers, and its ability to promote wound healing should be determined by confirmatory clinical trials

Recombinant human FGF-2 for the treatment of early-stage osteonecrosis of the femoral head: TRION, a single-arm, multicenter, Phase II trial

Aim: This study aimed to evaluate the 2-year outcomes from a clinical trial of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Patients & methods: Sixty-four patients with nontraumatic, precollapse and large ONFHs were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Setting the end point of radiological collapse, we analyzed the joint preservation period of the historical control. Changes in two validated clinical scores, bone regeneration and safety were evaluated. Results: Radiological joint preservation time was significantly higher in the rhFGF-2 group than in the control group. The ONFHs tended to improve to smaller ONFHs. The postoperative clinical scores significantly improved. Thirteen serious adverse events showed recovery. Conclusion: rhFGF-2 treatment increases joint preservation time with clinical efficacy, radiological bone regeneration and safety

Treatment algorithm of ACTH deficiency

Objective : To examine diagnostic performance of corticotropin-releasing hormone (CRH) test combined with baseline dehydroepiandrosterone sulfate (DHEA-S) in patients with a suspect of central adrenal insufficiency. Methods : Patients (n=215) requiring daily or intermittent hydrocortisone replacement, or no replacement were retrospectively checked with their peak cortisol after CRH test and baseline DHEA-S. Results : None of 106 patients with the peak cortisol ≥ 17.5 μg / dL after CRH test required replacement, and all 64 patients with the peak cortisol < 10.0 μg / dL required daily replacement. Among 8 patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL and baseline DHEA-S below the reference range, 6 patients required daily replacement and 1 patient was under intermittent replacement. Among 37 patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL and baseline DHEA-S within the reference range, 10 and 6 patients were under intermittent and daily replacement, respectively. Conclusions : No patients with the peak cortisol ≥ 17.5 μg / dL required hydrocortisone replacement, and all patients with the peak cortisol below 10.0 μg / dL required daily replacement. Careful clinical evaluation was required to determine requirement for replacement in patients with 10.0 μg / dL ≤ the peak cortisol < 17.5 μg / dL even in combination with baseline DHEA-S

看護学実習における「患者教育・指導」の指導方法の分析

看護学実習を看護学教育における、授業の一形態として位置づけた研究は始まったばかりである.本研究は、杉森等の看護学実習の内的構造を基に、「患者教育・指導」の実践力を修得することを目的にした、指導方法の分析の試みである.事例研究の方法で以下の点を明らかにする.1.実習における教材の教師の認識について2.教師-学生の相互行為について3.学生の実施する看護ケアの質の保証について

Clinical trials for drug approval : a pilot study of the view of doctors at Tokushima University Hospital

The development of new and useful pharmaceutical drugs is essential in order to improve the quality of drug therapeutics. Clinical trials play a central role in drug development. Over time, the clinical trial infrastructure has improved and is now integrating the contribution of clinical research coordinators (CRC). Nevertheless, the attitude of doctors towards clinical trials still favors conventional/historical methodologies. In the present study, we explored the view of doctors towards clinical trials for drug development, in order to improve communication among participants, sponsors, and investigators. A questionnaire was designed for this pilot study. The questionnaire included general attitudes, difficult points, the benefit of doctors in participating as investigators, special attention requirements, and the expected role of CRC in clinical trials for drug approval. In addition, the appropriate use of the outpatient clinic was examined. The questionnaire was provided to doctors in each department of Tokushima University Hospital in 2000 and 2004. Because of the small number of subjects included in this pilot study, no statistical analysis is presented. A total of 89 (81%) and62 (56%) doctors among 110 responded to the survey in 2000 and 2004, respectively. Inquiries about the familiarity of the physicians with clinical trials for drug approval revealed that 84% in 2000 and 66% in 2004 were aware of such trials. The attitude towards participating as investigators in the clinical trials was favorable, with a response of 66% in 2000 and 58% in 2004. Patients’ refusal and the informed consent process were considered difficult areas by many doctors. Expected roles of CRC included activities based on the nurse’s specialty. Although many doctors agreed to take care of the study participants separately from the clinical practice, they lacked the time to do so. In spite of the doctors’ workload reduction by introduction of the CRC concept, their views regarding clinical trials for drug approval remain conventional. Further refinement in the support process by CRC should be considered in our hospital, and the views of the doctors should be investigated in a larger study, in order to promote clinical trials for drug approval in Japan

看護大学生の卒業前看護技術演習の効果

今年度初めて,卒業前の学生に看護技術に対する不安の軽減を図ることを目的とした看護技術演習を行った。演習項目は,「経口薬の与薬」「筋肉注射」「点滴静脈注射」「輸液ポンプ」「採血」「膀胱内留置カテーテル挿入」「聴診」「経管栄養」「気管内吸引」である。指導には,教員の他に卒業生インストラクターが参加した。演習の参加は自由であり,参加した学生には無記名自記式質問紙により演習前の不安の強さと看護技術到達度について,演習後に,不安の変化と看護技術到達度の調査を行った。その結果,演習後に看護技術到達度は上昇し,学生の看護技術に対する不安は軽減した。卒業前の看護技術演習は,学生の看護技術に対する不安の軽減に効果があることが明らかとなった。また,卒業生インストラクターの参加は,学生が臨床に触れる機会となり新人看護職員研修のイメ-ジ化につながり,就職に対する不安を軽減する効果があると考えられた。Health Crisis management duties relating to specific food preparation and distribution facilities managed by Public Health Centres have been announced by the Ministry of Health, Labour and Welfare. According to these guidelines, nutritionally balanced meals should be safely provided, even in disastersituations. Therefore, such facilities should be prepared for disaster at all times and they should not neglect to ensure that they are able to provide help to each other in times of emergency. In this regard, after carrying outan assessment on the disaster preparation of some of these facilities in the city of Hamamatsu in ShizuokaPrefecture, results suggest that the organizational abilities of Registered Dietitians in Public Health Centresplay a very important role in disaster prevention training, which involves both regional and external participants

Lights of Seoul

Lights of Seoul, taken by Toshiko Abe on the Linfield College Semester Abroad Program in Seoul, South Korea. 2nd place, Judges\u27 Award division, in the 2010 Linfield College Study Abroad Photo Contest.https://digitalcommons.linfield.edu/intl_photos/1004/thumbnail.jp

Ethical climate and physical restraint use.

Ethical climate and physical restraint use

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