1.An Operative Case of Traumatic Aortic Regurgitation
Shinnosuke Okuma ; Takahiko Misumi ; Tsutomu Itou ; Akihiro Yoshitake ; Osamu Ishida ; Akinori Hirano
Japanese Journal of Cardiovascular Surgery 2013;42(3):179-182
Case reports of traumatic aortic regurgitation are rare. We report a case of a 62-year-old man injured by falling from a paraglider. After recovering from multiple injuries and discharge, he began to suffer from dyspnea. Severe aortic regurgitation and pseudoaneurysm of the sinus of Valsalva were diagnosed by ultrasound cardio graphy (UCG) and multi-detector-row computer tomography (MDCT). After cardiac failure was controlled, we operated. The commissure between the left and the right coronary cusps was detached from the aortic wall, and a modified Bentall operation was performed. The patient recovered well and was discharged uneventfully.
2.Workplace postgraduate education and changes in rehabilitation therapists’autonomy during the medical examination of stroke patients
Daisuke Nishio ; Shinichiro Maeshima ; Aiko Osawa ; Hidetaka Takeda ; Yoshitake Hirano ; Hiroshi Kigawa ; Hitoshi Maruyama
Medical Education 2014;45(2):87-92
Introduction: In the rehabilitation period following a stroke, rehabilitation therapists must thoroughly evaluate the condition of patients for the purposes of goal-setting and effective training. Postgraduate education in the medical examination of patients after stroke was provided for rehabilitation therapists, and changes in their autonomy during medical examinations were subsequently assessed.
Method: The education consisted mainly of reading case reports about patients who had strokes and learning neurological examination techniques. A total of 35 once-weekly education sessions were provided to rehabilitation therapists working in a convalescent rehabilitation ward. The rehabilitation therapists evaluated their independence with respect to obtaining patient backgrounds, vital signs, physical findings, neurological findings, laboratory results, and basic knowledge of illness at the beginning and end of the education sessions and 6 months after the sessions ended. Each evaluation item was compared according to the time of evaluation.
Results: Rehabilitation therapists’ autonomy over obtaining patient backgrounds, neurological findings, laboratory results, and basic knowledge of illness was greater at the end of the education sessions than at the start of the sessions. Their autonomy over obtaining information in these 4 areas and obtaining physical findings was greater 6 months after the end of the education sessions than at the start of the sessions.
Discussion: We conclude that workplace postgraduate training in the medical examination of patients who have had strokes improves rehabilitation therapists’ autonomy during medical assessments.