Notificación espontánea de errores de medicación en un hospital universitario pediátrico

OBJECTIVE: To analyze medication errors notified at a pediatric teaching hospital in São Paulo city. METHOD: Retrospective and descriptive study in which 120 error events and 115 spontaneous notifications were analyzed, between January 2007 and December 2008. RESULTS: The error rate was 1.15 per 1000 patients-day; 27.5% of notifications referred to the school age range and the Pediatric ICU was the sector with most notifications. The error type related to wrong infusion speed predominated (25%). The human factor dimension in the performance deficit category (54%) was the most frequent cause of error events. CONCLUSION: The safety culture is a continuous process in institutions and the notification of adverse events is part of the strategies. Improvement measures should be incorporated based on their analysis, whether related to the review of the work process or to team trainingOBJETIVO: Analizar los errores de medicación notificados en un hospital universitario pediátrico en el Municipio de São Paulo. MÉTODOS: Estudio descriptivo retrospectivo en el cual fueron analizadas 120 ocurrencias de errores de medicación registradas en 115 notificaciones espontáneas, entre enero del 2007 y diciembre del 2008. RESULTADOS: El índice de errores fue de 1,15 por 1.000 pacientes-dia; el 27,5% de las notificaciones involucraron pacientes en el grupo etáreo escolar. La Unidad de Cuidados Intensivos Pediátrico (UCIP) fue el sector con el mayor número de notificaciones. Predominó el tipo de error relacionado a la velocidad de infusión errada (25%). La dimensión factor humano en la categoría desempeño deficiente (54%) fue la causa más frecuente para la ocurrencia del error. CONCLUSIÓN: El índice de errores de medicación fue de 1,15 por 1.000 pacientes-dia, con predominio en el grupo etáreo escolar (27,5%) y en la UCI Pediátrica (35%). Frente a estos resultados, deben ser incorporadas medidas de mejora en la institución seleccionada, estén ellas relacionadas a la revisión del proceso de trabajo o a la capacitación del equipo.OBJETIVO: Analisar os erros de medicação notificados em um hospital universitário pediátrico no Município de São Paulo. MÉTODOS: Estudo descritivo retrospectivo no qual foram analisadas 120 ocorrências de erros de medicação registradas em 115 notificações espontâneas, entre janeiro de 2007 e dezembro de 2008. RESULTADOS: O índice de erros foi o de 1,15 por 1.000 pacientes-dia; 27,5% das notificações envolveram pacientes na faixa etária escolar. A Unidade de Terapia Intensiva Pediátrica (UTIP) foi o setor com o maior número de notificações. Predominou o tipo de erro relacionado à velocidade de infusão errada (25%). A dimensão fator humano na categoria desempenho deficiente (54%) foi a causa mais frequente para ocorrência do erro. CONCLUSÃO: O índice de erros de medicação foi de 1,15 por 1.000 pacientes-dia, com predomínio na faixa etária escolar (27,5%) e na UTI Pediátrica (35%). Diante desses resultados, medidas de melhoria devem ser incorporadas na instituição selecionada, sejam elas relacionadas à revisão do processo de trabalho ou à capacitação da equipe.Centro Universitário São Camilo Enfermagem GerencialUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem Departamento de Enfermagem PediátricaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Enfermagem Departamento de Administração e Saúde ColetivaUNIFESP, EPE Depto. de Enfermagem PediátricaUNIFESP, EPE Depto. de Administração e Saúde ColetivaSciEL

ガン カンジャ ニ タイスル エイヨウ リョウホウ

Cancer cachexia has been defined as a multifactorial syndrome defined by an ongoing loss of skeletal mass that cannot be fully reserved by conventional nutritional support and lead to progressive functional impairment. The diagnostic criterion for cachexia is weight loss greater than 5％, or weight loss greater than 2％ in individuals already showing BMI＜20 or sarcopenia. Multimodal management plan including nutrition, exercise, ant-inflammatory strategies, and other adjuncts is required for all cancer patients with anti-cancer therapy （operation, chemotherapy, radiotherapy） to avoid weight loss and keep quality of life. Enteral nutrition by means of oral nutritional supplements and tube feeding offers ensuring nutrient intake in cases when normal food intake is in adequate. Routine parenteral nutrition in chemotherapy does not improve prognosis

ガン カンジャ ニ タイスル エイヨウ リョウホウ

Cancer cachexia has been defined as a multifactorial syndrome defined by an ongoing loss of skeletal mass that cannot be fully reserved by conventional nutritional support and lead to progressive functional impairment. The diagnostic criterion for cachexia is weight loss greater than 5％, or weight loss greater than 2％ in individuals already showing BMI＜20 or sarcopenia. Multimodal management plan including nutrition, exercise, ant-inflammatory strategies, and other adjuncts is required for all cancer patients with anti-cancer therapy （operation, chemotherapy, radiotherapy） to avoid weight loss and keep quality of life. Enteral nutrition by means of oral nutritional supplements and tube feeding offers ensuring nutrient intake in cases when normal food intake is in adequate. Routine parenteral nutrition in chemotherapy does not improve prognosis

妊娠・産褥期における描画によるリラクセーション効果の検討 － POMS・筋硬度・口頭データを用いた心理・生理的評価－

　本研究の目的は，生理的指標と心理的指標を用いて，妊娠・産褥期における描画によるリラクセーション効果を検討することである．妊婦および褥婦5名を対象に，パステルによる描画前後に, POMS (Profile of Mood States) および肩部の筋硬度の測定を実施し，描画後に感想を求めた．描画前後のPOMSの6尺度の各得点および筋硬度比較を行った．また，描画した内容についてのテーマ毎の説明・感想，および全テーマの描画終了後の感想を記録し，質的に分析を実施した．描画前後のPOMSは，全員が緊張- 不安などのネガティブな気分の5尺度（T-A･D･A-H･F･C）の得点が下がり，活気得点（V）は上昇した．筋硬度は描画途中で授乳をした褥婦1名を除き描画後に低下した．テーマ毎の描画内容に関する説明・感想として，「自分」のテーマでは，「風に色がついている感じ」で「やわらかく柔軟になりたい」，「ピンクとかオレンジ」よりも「緑が欲しい」気分などが聞かれた．描画後の感想では，「力が抜ける」，「リラックスできる」，「あったかい」，「発汗」などがあった．今回の調査対象者は，描画後に，生理的指標である筋硬度及び心理的指標であるPOMSの測定でリラクセーション傾向を示した．全体終了後の感想でもリラックス感が表出された．また，描画の説明・感想より，色のイメージと気持ちの一致や色で自分を表現させていることが認められ，気持ちの表現に色などのパステル素材の効果があり，妊婦と褥婦にとっては描画が自己表出の機会となっていることが考えられた．パステルによる描画は心身両面に変化を与え，出産前後の女性の心身のリラクセーションに効果があることが示唆された．The purpose of this study was to examine the effects of relaxation evoked by drawing during pregnancy and the puerperal period by using a physiological index and a psychological index. Muscular tension of the shoulder and the Profile of Mood States (POMS) were assessed before and after drawing with pastels in 5 pregnant or puerperal women. After drawing, subjects gave their impressions of the experience, and POMS scores and muscular hardness measurements before and after drawing were compared. The impressions of drawing were qualitatively analyzed. After drawing, scores on 5 POMS scales for negative feelings had decreased, while the vigor score had increased. Muscular hardness also decreased after drawing, except in one puerperal participant who had suckled while drawing. The impressions of drawing with the theme of“ Myself” included feelings of“ I used the color of the wind”,“ I want to become flexible gently”, and“ I want to use green from pink and the orange”. Impressions of the entire drawing experience included “The tension in my body was relieved”, “I became relaxed”, “It became warm”, and “I started sweating”. After drawing, muscular hardness measurements and POMS scores indicated a tendency toward relaxation. The participants then matched the colors in images to feelings and expressed this connection with colors from their impressions of the drawing experience. The pastel material was effective for the expression of feelings. Drawing provided an opportunity for self-expression in the pregnant and puerperal women. The results suggest that drawing with pastels elicits a change in mind and body that can effectively help women to relax before and after birth

Lack of Association of Serotonin 2A Receptor Gene in Japanese Patients with Obstructive Sleep Apnea Syndrome

Article信州医学雑誌 65(3): 153-162(2017)journal articl

Genetic Polymorphism of Cancer Susceptibility Genes and HPV Infection in Cervical Carcinogenesis

It is widely accepted that specific human papillomavirus (HPV) types are the central etiologic agent of cervical carcinogenesis. However, a number of infected women do not develop invasive lesions, suggesting that other environmental and host factors may play decisive roles in the persistence of HPV infection and further malignant conversion of cervical epithelium. Although many previous reports have focused on HPV and environmental factors, the role of host susceptibility to cervical carcinogenesis is largely unknown. Here, we review the findings of genetic association studies in cervical carcinogenesis with special reference to polymorphisms of glutathione-S-transferase (GST) isoforms, p53 codon 72, murine double-minute 2 homolog (MDM2) gene promoter 309, and FAS gene promoter -670 together with HPV types including our recent research results

精神科看護継続教育に関する研究の動向

　本研究の目的は，１９９８年から２００７年の間に発表された，精神科看護継続教育に焦点を当てた研究を分析することにより，精神科看護継続教育研究の動向を明らかにし，精神科看護継続教育の発展に必要な研究内容や今後の研究遂行上の課題を検討することである．４７の文献を分析した結果，研究の出版年は最近５年間に集中していた．研究対象は，全国の看護師を対象としたもの１，県内の看護師を対象としたもの８，一病院の看護師を対象としたもの１５，一病棟の看護師を対象としたもの１０，認定看護師・専門看護師を対象としたもの２，事例８，その他３であった．論文の中で「取上げられている問題」を抽出し分析した結果【ニーズに合わない教育プログラム】【専門性の高い教育プログラムの不足】【中堅看護師の研修の不足】【継続性のない教育プログラム】【研修参加の障害】の５つのカテゴリーが明らかになった．改善のための「方法の提案」を抽出し分析した結果【個人のニーズを尊重した研修の企画】【専門性を高める教育プログラムの企画】【学ぶことを支援する体制】【現場で活かせる研修内容】【継続的な研修の企画】【中堅看護師の教育体制の充実】【新人教育の体系化】【地域教育ネットワークの充実】【看護基礎教育と継続教育とのつながりの明確化】の９つのカテゴリーが明らかになった．分析結果から個人のニーズを尊重し，個別性に対応した中堅看護師の継続教育とその支援が求められていた．対象とした研究には精神科継続教育のシステム開発に向けた研究はなかった．精神科看護継続教育のシステム開発に向け，精神科看護師の学習ニード，学習継続の要因についての研究が必要であることが示唆された．The purpose of this research is to analyze studies published between 1998 and 2007 that focused on continuing education for psychiatric nurses. In order to elucidate trends in research on continuing education for psychiatric nurses and examine future issues in research, we analyzed 47 articles. Those articles were mostly published within the last five years. The most common subjects were nurses at a single hospital (n=15), followed by nurses at a single ward (n=10), nurses within a prefecture (n=8), Certified Nurses and Certified Nurse Specialists (n=2), nurses nationwide( n=1), case studies( n=8), and other( n=3). Analysis of problems covered in research revealed the following five categories: "educational programs not meeting needs", "lack of educational programs with high expertise", "lack of training for mid-level nurses", "lack of continuity in educational programs", and "impediments to participation in training". Analysis of proposed methods revealed the following nine categories: "plans for training that onsiders individual needs", "plans for educational programs aimed at enhancing expertise", "systems for supporting learning", "training contents that can be applied in work settings", "plans for continuous training", "development of education systems for mid-level nurses", "systematization of education for new nurses", "development of regional education networks", and "clarification of the connection between basic nursing education and continuing education". No studies focused on development of a system for continuing education in psychiatric nursing. These findings suggest that more research is needed to determine the learning needs and factors among psychiatric nurses in order to develop the system for continuing education in psychiatric nursing

Insulin-like growth factor 1 modulates bioengineered tooth morphogenesis

Regenerative therapy to replace missing teeth is a critical area of research. Functional bioengineered teeth have been produced by the organ germ method using mouse tooth germ cells. However, these bioengineered teeth are significantly smaller in size and exhibit an abnormal crown shape when compared with natural teeth. The proper sizes and shapes of teeth contribute to their normal function. Therefore, a method is needed to control the morphology of bioengineered teeth. Here, we investigated whether insulin-like growth factor 1 (IGF1) can regulate the sizes and shapes of bioengineered teeth, and assessed underlying mechanisms of such regulation. IGF1 treatment significantly increased the size of bioengineered tooth germs, while preserving normal tooth histology. IGF1-treated bioengineered teeth, which were developed from bioengineered tooth germs in subrenal capsules and jawbones, showed increased sizes and cusp numbers. IGF1 increased the number of fibroblast growth factor (Fgf4)-expressing enamel knots in bioengineered tooth germs and enhanced the proliferation and differentiation of dental epithelial and mesenchymal cells. This study is the first to reveal that IGF1 increases the sizes and cusp numbers of bioengineered teeth via the induction of enamel knot formation, as well as the proliferation and differentiation of dental epithelial and mesenchymal cells