It is difficult to cool children with high fever by the conventional method because they cannot keep quiet in the bed, playing briskly or clinging on to their mother's bosom. We have devised new cooling methods available in any posture of the children. Cooling agents were packed into a rucksack or vest to cool the back, or into a rag doll to cool the axilla. The effectiveness of these devices was examined. The mothers of the patients at the age of 1 to 3 selected one of the three cooling methods randomly. As a result, the rucksack type were the vest type were accepted by their children for many hours, and were effective in lowering bode temperature in 65% of the cases. The mothers also seemed to like the new cooling methods. They commented that their children are free from restraint and the cooling devices are conveniently invisible for them.

  Specific activities of the working group include reviewing the assessment score sheet of all falls and the preventive measures by degree of risk, making staff education, training, monitoring the implementation of the safety and preventive recommendations for prevention of falls.
  The data of all inpatient falls which occurred during one year prior to and one year subsequent to the WG intervention were analyzed.
  The incidence of inpatient secondary falls, decreased from 155 to 108 , and reports of level III severe falls, showed a reduction from five cases to three. Statistically, the total percentage of secondary falls incidence decreased from 2.19‰ to 1.54‰.
  We therefore concluded that through the activities of the WG, the strengthening of the in-house system to prevent secondary falls, staff education, training, and heightened staff safety awareness have led to a decrease in the total number of primary and secondary inpatient falls.

Purpose: This study was to develop a scale to measure difficulties encountered by cancer care by nurses and to evaluate the reliability and the validity of the scale. Methods: Self-reported questionnaires were administered to nurses who are engaged in cancer care in Tohoku University Hospital. Results: Of 512 questionnaires distributed to nurses, 356 were completed and returned 70%. We selected 49 items in 6 domains, including "communication" "knowledge and skill" "collaboration with doctor" "disclosure and explanation of disease" "hospital system and regional alliances" and "death and dying" using explanatory factor analysis. Cronbach's α coefficient was 0.68 across domains and ranged from 0.69 to 0.74 for each domain. Construct validity was demonstrated and the scaling success rates were 100% for all domains on multitrait scaling analysis. In terms of the known groups validity, the score for the nurses in the palliative care unit was significantly lower than for nurses on the general wards. Conclusion: This study showed that the scale has sufficient reliability and validity. This scale may contribute to cancer nursing by assessing hospital nurses' perception of cancer care and as a method of determining outcomes of educational or organizational interventions.

The purposes of this study were to describe nurses’ difficulty with cancer care and explore factors related to the difficulty of cancer care. Self－reported questionnaires were distributed to 512 nurses who are engaged in cancer care at Tohoku University Hospital. Responses from 344 (67％) nurses were subjected to analysis. The results revealed that nurses felt that “communication” was the most difficult aspect of cancer nursing followed by “hospital system and regional alliances” and “knowledge and skill.” Nurses did not feel that “collaboration with doctors” “disclosure and explanation of disease” or “death and dying” had particularly high levels of difficulty, however, their levels of difficulty could be improved. Greater difficulty with cancer care was reported by nurses working on the general ward and nurses with limited cancer care experience in the last year. Communication skill training,education (especially for less experienced nurses), expansion of palliative care, and restructuring of discharge planning and regional collaboration systems might contribute to decreasing nurses’ difficulty with cancer care.

BACKGROUND: Minocycline-induced pigmentation of bone (black bone) is well described in tooth-bearing intra-oral bone, but is less known in periarticular bone in patients who have undergone total joint arthroplasty. On a retrospective basis, we investigated the short-term clinico-radiological results of total joint arthroplasties in which the patient developed minocycline-induced periarticular black bone. METHODS: We found 5 cases (0.08%), in 4 patients, of periarticular bone pigmentation revealed during total joint arthroplasties (2 hips, 2 knees, and 1 ankle) in our series of total joint surgeries (6,548 cases) over a 10-year time period in our 3 institutes. Their mean age was 56 years at surgery. All patients had received long-term minocycline treatment. Mean dosage and duration of minocycline was 160 mg/day and 2.2 years, respectively. Minocycline had been prescribed for reactive arthritis (one), rheumatoid arthritis (two) and late infection after total joint arthroplasty (two patients). Mean follow-up period was 3.4 years after the surgeries. RESULTS: All cases had black or brown pigmentation in the periarticular bones during the surgery. There was no pigmentation in the cartilage or soft tissues of the joints. The mean Japanese Orthopaedic Association (JOA) score or Japanese Society for Surgery of the Foot (JSSF) scale for rheumatoid arthritis foot and ankle joints at latest follow-up (case 1, 66; case 2, 87; case 3, 77; case 4, 77; case 5, 80) improved compared to those of pre-surgery (case 1, 47; case 2, 45; case 3, 55; case 4, 34; case 5, 55). No implant loosening was noted on radiographic examination during the follow-up period. No abnormal bone formation, bone necrosis, hemosiderin deposition, malignancy or metallic debris was found on histological examination. CONCLUSIONS: No clinico-radiological symptoms of total joint arthroplasties showed in the patients with minocycline-induced periariticular black bone in the short-term. Systemic minocycline treatment has the potential to induce significant black pigmentation of many tissues. In particular, minocycline-induced pigmentation of periarticular bone may be accelerated by inflammation due to rheumatic or pyogenic arthritis. Surgeons should recognize the risk of bone pigmentation in inflamed joints due to the systemic treatment of minocycline and explore its influence on periarticular bone and total joint arthroplasty in the long-term.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Antibiotic Prophylaxis/adverse effects ; Arthritis/drug therapy/*pathology/prevention & control ; Arthroplasty, Replacement/*methods ; Bone and Bones/*drug effects/pathology ; Female ; Humans ; Male ; Middle Aged ; Minocycline/*adverse effects/therapeutic use ; Retrospective Studies ; Skin/pathology ; Skin Pigmentation

The venerable drug colchicine has garnered significant recent attention due to its endorsement by the United States Food and Drug Administration as an anti-inflammatory medication for cardiovascular diseases. However, the administration of this drug at its minimal available dose of 0.5 mg has been associated with certain adverse reactions.Once colchicine is administered, the drug disappears from blood in a short time and distributes in the leukocytes for a certain period of time that elicits anti-inflammatory effect.Consequently, an in-depth comprehension of the pharmacokinetics of lower dosages within leukocytes assumes important for its broader application in routine clinical contexts. In this study, we present a comprehensive analysis of the pharmacological disposition of colchicine in the plasma, polymorphonuclear leukocytes, and mononuclear leukocytes among healthy Japanese male subjects, following both single and multiple oral administrations of 0.5 mg and 0.25 mg doses of colchicine. Our investigation reveals that colchicine persists within leukocyte populations even when administered at reduced dosages. The findings herein hold promise for mitigating the adverse effects associated with its use in the treatment of inflammatory cardiovascular disorders.