1.Usefulness of Electronic Mailing as an In-Hospital Drug Information Transmittal System: Assessment of Active Transmissions for Adverse Effect Information
Satoru Ezumi ; Satoshi Kuroda ; Hisashi Matsunaga ; Toshiaki Sendo
Japanese Journal of Drug Informatics 2012;13(4):160-166
Objective: In the management of drug information, pharmacists are required to appropriately transmit information to the corresponding medical staff. However, it is unclear whether the transmitted information is received and utilized effectively. In this study, we assessed the effectiveness of drug safety information transmitted to doctors by pharmacists and investigated the requirements of doctors for the transmitted drug safety information in Okayama University Hospital.
Design and Methods: We performed the assessment via questionnaire from doctors who had been sent drug safety information by electronic mail (e-mail) from January to October 2010. The return rate and responses for the questionnaire were investigated.
Results: For the study time period, 15 cases of e-mail drug safety information transmissions occurred. The questionnaire was sent to 204 doctors, and the recovery rate of the questionnaire was 46.1%. Seventy-six percent of doctors who responded to the questionnaire answered that the e-mail information was useful for the clinical practice. Among the comments, it was noted that an improvement in the content of e-mail information would allow doctors to access the required information more conveniently.
Conclusion: In this study, it was demonstrated that the majority of doctors were satisfied with the transmission of drug safety information using e-mail, although some improvement was needed. Furthermore, it was considered that the feedback assessment and re-construction of information transmittal system were important to improve usability and availability of the drug information service.
2.PROTEIN METABOLISM OF RURAL DIABETIC PATIENTS
kyohei itô ; toshiaki matsunaga ; teruo takada ; norihiko nonozaki ; sumiko mineno ; kazuhiko furuta ; noriko wakasugi
Journal of the Japanese Association of Rural Medicine 1966;13(3-4):245-249
For the purpose of elucidating the conditions of diabetic patients in rural areas, we have been undertaking some statistical studies in regard to various pathological aspects of diabetic patients being treated at our hospital on the outskirts of Nagoya City, as well as those discovered by diabetes mass examinations. This it to report on the total serum protein values and serum protein fractions (by electrophoresis), measured for the study of protein metabolism.
Group I. Diabetic patients treated at our hospital. No remark-able change was observed in their total serum protein value. In their serum protein fractions, a decrease in albumin value and A/G ratio and a slight increase of α 1-, α 2-, β-and β-globulin values. On the other hand diabetic patients with renal complications showed a decrease in total serum protein value, albumin value and A/G ratio, a slight increase in α 1-, α 2-, and γ-globulin values, and a slight decrease in γ-globulin value.
Group II. Insidious asymptomatic cases discovered by mass examinations. No remarkable change was observed in total serum protein value. A for serum protein fractions, they showed a decrease in albumin value and A/G ratio, and an increase in all glabulin fractions. Furthermore. increase of α 1 fraction was more conspicuous in women, that of α 2 in women and in both sexes with renal complications, that of β-and γ-globulin in women, farmers and those with renal complications.
These findings oriented us farther to the analysis of relation-ship between diabetes mellitus and various environmental factors.
3.Five autopsy cases of paraquat poisoning
Hajime Kuhara ; Takashi Wakabayashi ; Hidemasa Kishimoto ; Katsuji Hayashi ; Taizan Suti ; Toshiaki Matsunaga
Journal of the Japanese Association of Rural Medicine 1977;26(4):647-656
Five autopsy cases of poisoning by the weed killer paraquat (Gramoxone) are presented.
Case 1. A 33-year-old female swallowed about 150 ml of Gramoxone. She died after 11 hours of intoxication.
Abnormal post-mortem findings were confined to the lungs, the kidneys and the adrenals. Histologically, the lungs showed congestion and edema; the kidneys showed tubular' degeneration and necrosis; and the adrenals showed cortical degeneration and necrosis.
Case 2. A 74-year-old male swallowed about 20 ml of Gramoxone. He died on the 4th day of ingestion of Gramoxone.
Histologically, the lungs were congestive and there were a moderate degree of hyperplasia of alveolar septa.
Alveolar spaces contained edematous fluid containing fibrin. Some skeletal muscle fibers were variable in size, and showed degenerative changes including vacuolization. The adrenal cortex was atrophic.
Case 3. A 44-year-old female swallowed about 20 ml of Gramoxone. She died on the 8th day of ingestion. The lungs were both congestive and edematous. Alveolar spaces contained edematous fluid with a trace amount of fibrin. The kidneys showed tubular degeneration. The liver showed a moderate degree of fatty changes in the central zones.
Acute oesophagitis and acute ulcerative change in the stomach were noticed.
Case 4. A 45-year-old male swallowed about 90 ml of Gramoxone. He died after 12 hours of intoxication. Histologically, the lungs were remarkably congestive and edematous. There were fatty changes in the central areas of the liver. Acute gastritis were noticed.
Case 5. A 32-year-old female swallowed about 15 ml of Gramoxone. She died on the 28th day of ingestion. At post-mortem examination, the lungs were solid and atelectatic. Histologically, the lungs showed generalized, severe degree of fibrosis together with desquamative changes of alveolar epithelium and PAS-positive hyaline menbrane formations. The liver showed a moderate degree of fatty changes in the central areas. The skeletal muscle fibers were variable in size showing a moderate degree of vacuolar and targetoid changes.
Various amounts of Paraquat were detected in the lungs, the livers, the kidneys and the muscles of case 1 and 4, in the fatty tissues and the brain of case 1 using formalin-fixed specimens.
Degenerative changes of skeletal muscle fibers presented in this report may be ascribed to the effect of Praquat in the light of the literature.