1.Activities of Breathing Care Team Led by Certified Respiratory Therapists in Our Hospital and Future Problems
Keisuke YASUMOTO ; Koji MIYAWAKI ; Hideki MINAMI ; Keiko IZUMI ; Koushou TANAKA ; Takashi KANEYUKI
Journal of the Japanese Association of Rural Medicine 2013;62(4):618-621
Introduction: Reimbursement for breathing care services was started with the revision of the nation's medical service fee system in 2010. Our hospital was not properly equipped in the light of certain standards governing facilities. Nonetheless, we started giving instructions to nurses on how to check the respirator at work. In addition to the on-the-job training, we are engaged in educational activity and information gathering. Out team comprises clinical engineers, physical therapists and registered nurses. They are all certified respiratory therapists. We hereby report our activities and refer to future problems. Activities: 1. Safety checks of respirators while in use. 2. Respiratory rehabilitation during hemodialysis. 3. Respirator-related workshops. 4. Review of accidents. Results: 1. It has become easier to discover potential problems and meet them at once. This is because our team is made up of different specialists, each used to looking at things differently. 2. Being constantly on the alert for any indication of a trouble ensures safety during breathing rehabilitation. 3. The number of accidents during 2012 decreased from 2011. Future: We think that since “safety management” is the center piece of our activity, our team ought to be recognized as an official organization of the hospital.
2.Assessment of abdominal visceral fat measured by dual bioelectrical impedance analysis in rugby football players
Chiaki Yamashita ; Kayoko Yamazaki ; Yuri Kanesada ; Takashi Miyawaki ; Reiko Nakayama ; Shingo Okazaki ; Naoko Komenami
Japanese Journal of Physical Fitness and Sports Medicine 2015;64(2):251-259
Visceral fat accumulation is a notable risk factor in the incidence of lifestyle-related diseases such as metabolic and circulatory disorders. In this study, we measured visceral fat area (VFA) and subcutaneous fat area (SFA) in rugby football players by using dual bioelectrical impedance analysis, as well as other metabolic and circulatory parameters. A total of 28 male players (15 forwards, 13 backs; mean age±SD: 23±4 years) participated in this study. VFA and SFA were significantly correlated with body weight. Thus, heavier players had higher VFA and SFA as well as higher body weight. In addition, VFA was significantly correlated with various blood parameters such as alanine aminotransferase, gamma-glutamyl transpeptidase, and triglyceride. Six of the 28 players met the criteria for visceral obesity, defined as both body mass index ≥25 kg/m2 and VFA ≥100 cm2. In some of these players, blood parameters such as high-density lipoprotein cholesterol <40 mg/dL, triglyceride ≥150 mg/dL, or systolic blood pressure ≥130 mmHg indicated elevated risk for metabolic syndrome. These findings suggest that in athletes like heavier rugby football players, abdominal visceral fat accumulation may indicate risk of lifestyle-related diseases.
3.A Case of Left Ventricular Free Wall Rupture (Blow Out) after Acute Myocardial Infarction and Interventional Catheterization.
Tatsunori Kimura ; Takashi Miyamoto ; Masao Chujo ; Hatsuo Moriyama ; Mitsuko Fukunaga ; Michiyo Miyawaki ; Natsuki Nakamura
Japanese Journal of Cardiovascular Surgery 1998;27(3):166-168
A 66-year-old man suddenly fell into a state of shock on his way back to his room after emergency coronary angiography and intracoronary thrombolysis for acute myocardial infarction. Both echocardiography and pericardiocentesis suggeted a diagnosis of cardiac rupture. The patient was transferred to an operating room with a percutaneous cardiopulmonary support system (PCPS) and intraaortic balloon pumping. Following thoracotomy and release of cardiac tamponade, blow out rupture of the left ventricular free wall was detected. The rupture was repaired using triple mattress sutures by reinforcing with felt pledgets. An infarctectomy was not added and cardiopulmonary bypass was not used. Postoperative recovery of cardiac function was satisfactory and the left ventricular ejection fraction after 2 months was 35%. PCPS and consecutive surgical therapy are effective for the treatment of blow out rupture of the left ventricular free wall.