1.Active Learning through an Integrated Curriculum: Making Use of Human Anatomy Practice
Hiroyuki Ichijo ; Tomoya Nakamura ; Yuichi Takeuchi ; Masahumi Kawaguchi
Medical Education 2016;47(6):343-351
Students always have many questions and problems during active participation. Here, we report an active learning course (AL) based on problems that medical students encountered in gross anatomy practice. This AL was implemented after the practice, consisting of a lecture, group discussions, resource hours, and presentation session to ensure exploratory learning. Based on a questionnaire survey, 75.1% of the students evaluated the AL as very valuable or valuable, indicating its usefulness. The AL not only complemented the anatomy course, but also directed the students toward other forms of basic and clinical learning. The results indicate that by making use of gross anatomy practice, the AL functions as a hub for horizontal and vertical integrations in medical education.
2.The Predictive Value of Glycated Hemoglobin and Albumin for the Clinical Course Following Hospitalization of Patients with Febrile Urinary Tract Infection.
Minoru KOBAYASHI ; Toshitaka UEMATSU ; Gaku NAKAMURA ; Hidetoshi KOKUBUN ; Tomoya MIZUNO ; Hironori BETSUNOH ; Takao KAMAI
Infection and Chemotherapy 2018;50(3):228-237
BACKGROUND: Diabetes is considered a risk factor for acquisition of febrile urinary tract infection (f-UTI), but information on the association of diabetes with subsequent course of the disease is lacking. Thus, we investigated the clinical variables including diabetic status which determined the clinical course in patients with community-acquired f-UTI. MATERIALS AND METHODS: Patients hospitalized consecutively for f-UTI between February 2016 and January 2018 were used for this single center study. The routine laboratory tests including blood glucose and glycated hemoglobin (HbA1c) were done and empiric treatment with parenteral antibiotics was commenced on admission. The clinical course such as duration of fever (DOF) and length of hospital stay (LOS) were compared among groups classified by the clinical variables. RESULTS: Among the101 patients admitted for f-UTI, 15 patients with diabetes (14.9%) experienced significantly longer febrile period and hospitalization compared to those with hyperglycemia (n = 18, 17.8%) or those without diabetes and hyperglycemia (n = 68, 67.3%). Of the laboratory parameters tested on admission and several clinical factors, the presence of diabetes and risk factors for severe complicated infection (hydronephrosis, urosepsis, and disseminated intravascular coagulopathy) as well as HbA1c and albumin were identified as predictors for LOS by univariate analysis, whereas none of the variables failed to predict DOF. In the subsequent multivariate analysis, HbA1c levels and albumin levels were isolated as independent predictors of LOS. CONCLUSION: Patients with higher HbA1c and lower albumin levels required the longest period of hospitalization. Thus, an evaluation of diabetic and nutritional status on admission will be feasible to foretell the clinical course and better manage the subset of patients at risk of prolonged hospitalization.
Anti-Bacterial Agents
;
Blood Glucose
;
Fever
;
Hemoglobin A, Glycosylated*
;
Hospitalization*
;
Humans
;
Hyperglycemia
;
Length of Stay
;
Multivariate Analysis
;
Nutritional Status
;
Risk Factors
;
Urinary Tract Infections*
;
Urinary Tract*
3.The Predictive Value of Glycated Hemoglobin and Albumin for the Clinical Course Following Hospitalization of Patients with Febrile Urinary Tract Infection.
Minoru KOBAYASHI ; Toshitaka UEMATSU ; Gaku NAKAMURA ; Hidetoshi KOKUBUN ; Tomoya MIZUNO ; Hironori BETSUNOH ; Takao KAMAI
Infection and Chemotherapy 2018;50(3):228-237
BACKGROUND: Diabetes is considered a risk factor for acquisition of febrile urinary tract infection (f-UTI), but information on the association of diabetes with subsequent course of the disease is lacking. Thus, we investigated the clinical variables including diabetic status which determined the clinical course in patients with community-acquired f-UTI. MATERIALS AND METHODS: Patients hospitalized consecutively for f-UTI between February 2016 and January 2018 were used for this single center study. The routine laboratory tests including blood glucose and glycated hemoglobin (HbA1c) were done and empiric treatment with parenteral antibiotics was commenced on admission. The clinical course such as duration of fever (DOF) and length of hospital stay (LOS) were compared among groups classified by the clinical variables. RESULTS: Among the101 patients admitted for f-UTI, 15 patients with diabetes (14.9%) experienced significantly longer febrile period and hospitalization compared to those with hyperglycemia (n = 18, 17.8%) or those without diabetes and hyperglycemia (n = 68, 67.3%). Of the laboratory parameters tested on admission and several clinical factors, the presence of diabetes and risk factors for severe complicated infection (hydronephrosis, urosepsis, and disseminated intravascular coagulopathy) as well as HbA1c and albumin were identified as predictors for LOS by univariate analysis, whereas none of the variables failed to predict DOF. In the subsequent multivariate analysis, HbA1c levels and albumin levels were isolated as independent predictors of LOS. CONCLUSION: Patients with higher HbA1c and lower albumin levels required the longest period of hospitalization. Thus, an evaluation of diabetic and nutritional status on admission will be feasible to foretell the clinical course and better manage the subset of patients at risk of prolonged hospitalization.
Anti-Bacterial Agents
;
Blood Glucose
;
Fever
;
Hemoglobin A, Glycosylated*
;
Hospitalization*
;
Humans
;
Hyperglycemia
;
Length of Stay
;
Multivariate Analysis
;
Nutritional Status
;
Risk Factors
;
Urinary Tract Infections*
;
Urinary Tract*
4.An Update of Sports Medicine in Persons with Disabilities—Surviving Skeleton Muscles are Endocrine Organs—
Fumihiro TAJIMA ; Kazunari FURUSAWA ; Taro NAKAMURA ; Hidenobu OKUMA ; Yuichi UMEZU ; Makoto IDE ; Takashi MIZUSHIMA ; Mari UETA ; Takeshi NAKAMURA ; Takamitsu KAWAZU ; Hideki ARAKAWA ; Tomoyuki ITO ; Midori YAMANAKA ; Ken KOUDA ; Masaki GOTO ; Yusuke SASAKI ; Nami KANNO ; Takashi KAWASAKI ; Yasunori UMEMOTO ; Tomoya SHIMOMATSU ; Motohiko BANNO ; Hiroyasu UENISHI ; Hiroyuki OKAWA ; Ko ASAYAMA
The Japanese Journal of Rehabilitation Medicine 2010;47(5):304-309