2021年度コロナ禍における基礎看護技術実習 ー動画教材を用いた学内実習と成果ー

2021 年度「基礎看護技術実習」は、新型コロナウイルス感染症の感染者数の増加のため臨地実習ができず、学内実習にきりかえた。実習目標を達成するために担当した教員で学内実習方法を考案して実施した。実習方法は以下とした。まず病院環境を観察することができるように、教員が実際の病院の 1 施設を訪れて動画撮影を行い教材とした。看護の「観察」には DVD「プロフェッショナル仕事の流儀」で登場する二人の専門看護師の活動を視聴した。学生は所定の行動計画用紙にもとづいて記述し、カンファレンスで視聴した共通画面をとりあげ議論をすることによって倫理的視点や看護行為について理解を深めた。「自分の考えの根拠となった場面」「考察」「結論」に一貫性のある学生４名の記述内容を分析した。本稿では、担当した教員の発言を要約、整理し、動画教材を用いた学内実習の成果として学生の観察能力の向上および看護師の役割の理解、看護行為における倫理的視点について考察し、報告する

転移性尿路上皮癌に対するGC療法における，Gemcitabine投与後の発熱の臨床的意義の検討：多施設共同後ろ向き研究

Gemcitabine（GEM）の有害事象として発熱があるが，その臨床的意義は不明である．今回GEMとcisplatinによるGC療法中の発熱の頻度，背景因子および予後との関連について検討した．対象は転移性尿路上皮癌に対してGC療法を施行した184例について後方視的に検討した．発熱は44例（23.9%）で認められ，多変量解析で治療直前のCRP 高値が発熱の有意な予測因子であった（オッズ比2.450，p=0.041）．また発熱群は非発熱群と比較し癌特異的生存期間が有意に短かった（中央値 12.0 ヶ月vs15.8 ヶ月，p=0.045））．転移性尿路上皮癌におけるGEM投与時に発熱した症例は予後不良である可能性が示唆された

Spontaneous Infection of an Atrophic Ureter with an Ectopic Ureteral Opening after Living-Donor Renal Transplantation in a Patient with Kabuki Syndrome

A 24-year-old woman with a high fever presented at our hospital. She had been diagnosed with Kabuki syndrome at the age of 4 years because she had the typical facial features of the condition ; she had undergone living donor renal transplantation 12 years prior. She was prescribed a course of antibiotics to treat pyelonephritis of the transplanted kidney and the high fever disappeared, but the fever developed again 3 days after the discharge. Abdominal computed tomography revealed a tubular structure of recent onset running from the left dorsal side to the lower part of the bladder. This structure was filled with pus, which we drained. We also performed laparoscopic ureterectomy of the left ureter to achieve a complete cure. No complication was observed after the surgery and the graft renal function did not deteriorate further

The Relationship Between Prognosis and Duration of Drug Holidays after Docetaxel Therapy for Castration-Resistant Prostate Cancer

本論文の要旨は，日本泌尿器腫瘍学会第8回学術集会で発表を行った．The next treatment strategy after drug holidays following docetaxel (DTX) therapy for patients with castration-resistant prostate cancer (CRPC) is unclear. This study investigated the relationship between the duration of drug holidays and prognosis after DTX therapy. This study retrospectively assessed 26 patients treated with DTX in our hospital. Overall survival duration was significantly longer in the long-term withdrawal group (duration of drug holidays ≥6 months) than in the short-term withdrawal group (duration of drug holidays ＜6 months) (P＝0.015). Similarly, progression-free survival duration was significantly longer in the long-term withdrawal group than in the short-term withdrawal group (P＝0.008). The short-term withdrawal group had a significantly lower body mass index (P＝0.009) and higher prostate-specific antigen (PSA) (P＝0.017) at the initiation of DTX therapy, higher PSA nadir during DTX therapy (P＝0.009), and higher PSA at the end of DTX therapy (P＝0.022), compared to the long-term withdrawal group. This study suggests that the optimal opportunity to introduce DXT therapy is when the patients with CRPC are physically able to tolerate chemotherapy and their tumor volume remains a lower burden. This may provide a clinical benefit, longer drug holidays, and a better prognosis

タイイクカ モギジュギョウ ニ オケル キョウドウテキ ナ セイサツ ノ ジッタイ ハツワ ナイヨウ ノ チシキ ノ ヒンド ニ チャクモク シテ

The purpose of this study was to survey the actual situation of cooperative reflection in Physical Education trial lessons focused on reflective content and frequency of knowledge comments. To accomplish this purpose, we conducted reflective discussion with the teachers and the students who had roles as teacher, student and observer after the trial lessons. We recorded their discussion and analyzed them with the perspective of knowledge; content knowledge, pedagogical knowledge and knowledge of the students. 　The results of the analysis showed that reflective content had been conducted with various perspective points because the teachers and the students who had separate roles as teachers and students had different knowledge. In addition, if there were only students, but the roles are different, then their perspectives would also differ. However, there was an overall tendency that their knowledge was not observable during the progress of the unit