1.Quality of life improvement in patients diagnosed with hormone refractory prostate cancer with bone metastasis as a result of chemotherapy and the administration of zoledronic acid
Maki Arakawa ; Hiroko Saito ; Takaaki Hasegawa ; Yasuto Kato ; Kiyohito Ishikawa
Palliative Care Research 2008;3(2):308-315
Bone metastases occur in patients who have developed prostate cancer, and severely compromise the patient's quality of life. Here, we evaluated the quality of life in our inpatients diagnosed with prostate cancer with multiple bone metastases and bone pain. In our study, we evaluated pain using a pain diary, investigated the palliative effects of opioid dose, and assessed the quality of life using SF-36. The administration of chemotherapy and zoledronic acid (ZA) resulted in pain palliation, an anti tumor effect and improvements in the quality of life. We suggest that the administration of ZA might be an effective clinical strategy for multimodality advanced solid cancer therapy. We conclude that a 'combined' examination, in which a pain diary evaluating pain is considered in association with an SF-36 assessment evaluating quality of life is crucial to patient care. Palliat Care Res 2008 ; 3(2) : 308-315
2.Influence of a Liaison-clinical Pathway on the Length of Stay and the Functional Independence Measure Gain of Stroke Patients in the Nakaharima and Nishiharima District Medical Facilities Network in Hyogo Prefecture
Goro OHSAKA ; Junichi KATO ; Yasuto HIGASHI ; Masanobu USUI ; Yoichi TERAMOTO ; Naoki SAJI
The Japanese Journal of Rehabilitation Medicine 2011;48(11):717-724
Objective : The aim of this study was to examine the influence of a liaison-clinical pathway for stroke rehabilitation. Methods : We initiated the pathway in January 2008. The patients enrolled in this study included 82 patients with acute stroke sustained during the 4 months after the initiation of the pathway and 151 patients with acute stroke sustained during the same period in the following year. Results : The mean length of stay in acute stroke centers was significantly reduced in the second year of employing the pathway. However, an evident reduction of the functional independence measure gain was observed in the convalescent rehabilitation wards, especially in severely physically handicapped patients. Conclusion : The liaison-clinical pathway is an effective approach for advancing a regional cooperation network among hospitals and for shortening the stay in acute stroke centers. On the other hand, the clinical outcome of stroke patients can deteriorate if enough efforts are not made to improve the medical management of severely physically handicapped patients in convalescent rehabilitation wards.