癌の化学療法に関する研究 特に制癌剤並びに制癌強化剤の担癌生体内代謝に及ぼす影響について

Background: Medication related harm (MRH) is a common cause of morbidity and hospital admission in the elderly, and has significant cost implications for both primary and secondary healthcare resources. The development of risk prediction models has become an increasingly common phenomenon in medicine and can be useful to guide objective clinical decision making, resource allocation and intervention. There are no risk prediction models that are widely used in clinical practice to identify elderly patients at high risk of MRH following hospital<br/>discharge. The aim of this study is to develop a risk prediction model (RPM) to identify elderly patients at high risk of MRH upon discharge from hospital, and to compare this with routine clinical judgment.<br/><br/>Methods/Design: This is a multi-centre, prospective observational study following a cohort of patients for 8 weeks after hospital discharge. Data collection including patient characteristics, medication use, social factors and frailty will take place prior to patient discharge and then the patient will be followed up in the community over the next 8 weeks to determine if they have experienced MRH. Research pharmacists will determine whether patients have<br/>experienced MRH by prospectively reviewing records for unplanned emergency department attendance, hospital readmission and GP consultation related to MRH. Research pharmacists will also telephone patients directly to<br/>determine self-reported MRH, which patients may not have sought further medical attention for. The data collected will inform the development of a RPM which will be externally validated in a follow-up study. <br/><br/>Discussion: There are no RPMs that are used in clinical practice to help stratify elderly patients at high risk of MRH in the community following hospital discharge, despite this being a significant public health problem. This study plans to develop a clinically useful RPM that is better than routine clinical judgment. As this is a multi-centre study<br/>involving clinical settings that serve elderly people of heterogeneous sociodemographic background, it is anticipated that this RPM will be generalizable

Reclamation status of a degraded pasture based on soil health indicators

Pasture degradation is a concern, especially in susceptible sandy soils for which strategies to recover them must be developed. Microbiological and biochemical soil health indicators are useful in the guindace of soil management practices and sustainable soil use. We assessed the success of threePanicum maximum Jacq. cultivars in the reclamation of a pasture in a sandy Typic Acrudox in the northwest of the state of Paraná, Brazil, based on soil health indicators. On a formerly degraded pasture withUrochloa brizantha (Hochst. ex A. Rich.) R.D. Webster, a trial with threeP. maximum (cv. Massai, Tanzânia, or Mombaça) was conducted. Lime and phosphate were applied at set-up, and mineral N and K as topdressing. A remnant of degraded pasture adjacent to the trial was used as control. Twenty-three chemical, physical, microbiological and biochemical attributes were assessed for the 0-10 cm topsoil. The procedures for reclamation improved most of the indicators of soil health in relation to the degraded pasture, such as soil P, mineral N, microbial biomass C, ammonification rate, dehydrogenase activity and acid phosphatase. CO2 evolution decreased, whereas microbial biomass C increased in the pasture under reclamation, resulting in a lower metabolic quotient (qCO2) that points to a decrease in metabolic stress of the microbial community. The reclamation of the pasture withP. maximum, especially cv. Mombaça, were evidenced by improvements in the microbiological and biochemical soil health indicators, showing a recovery of processes related to C, N and P cycling in the soil