1.Looking Back on the Past One Year Since the Opening of the Chemotherapy Unit for Outpatients
Masayo NOMURA ; Hitomi MURAO ; Hideko TERADA
Journal of the Japanese Association of Rural Medicine 2004;53(2):161-166
The chemotherapy unit of our hospital came into existence in April 2002. Since then, we, nurses, have teamed up together in support of cancer patients who visited us for receiving chemotherapy. We investigated the use of the facilities during the first 12 months since the opening of the unit, and made a questionnaire survey to sound out the degree of the patients’ satisfaction and needs. This paper describes our findings.The number of patients who used the chemotherapy unit came to 1,213. The questionnaire survey were conducted on 40 outpatients who initially had visited the department of surgery of our hospital. Of the patient supporting tools, the self-help notebooks were utilized by 27 patients. Those patients who said they took nurses into their confidence numbered 34. They expressed their anguish and uneasy feelings in connection with the condition of their disease and treatment. The same number of patients replied that they wanted to receive chemotherapy even if extra charges were involved. From these findings, it could be said that the patients’satisfaction was great. However, it was also suggested that to obtain the informed consent from the patients there should be explanatory leaflet which explain the therapeutic procedure and additional fees in plain language, that repeated instructions about side effects should be given orally, and that nurses are required to occasionally act as moderators between the unit and other departments in accordance with the patients’wishes. These are some of the patients’needs. To fill them, further studies must be made.
Chemotherapy-Oncologic Procedure
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Unit
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findings
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Satisfaction
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One
3.Therapy-Related Myelodysplastic Syndromes in an Ovarian Carcinoma Patient Following Treatment with Paclitaxel- and Carboplatin-Based Regimens
Masahiro MURAKAMI ; Hiroshi IKAWA
Journal of the Japanese Association of Rural Medicine 2008;57(6):873-877
Progress in chemotherapeutic strategy has significantly decreased side effects of the drugs used and greatly added to survival rates for ovarian cancer. On the other hand, the occurrence of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) has been reported after long-term chemotherapy. We encountered a case of therapy-related MDS that developed as a consequence of chemotherapy. A 59-year-old woman (gravida 2, para 2) stage IIIc ovarian cancer received three courses of paclitaxel and carboplatin therapy (TC) prior to primary surgery, and 16 courses of weekly TC as adjuvant chemotherapy. She exhibited pacritaxel-associated hypersensitivity reactions in the last course, so that chemotherapy was discontinued. Following three mouths of remission, a sudden rise in her tumor markers and an increase in the size of her pelvic lymphonode were discovered on PET-CT. She recieved multiple courses of chemotherary of docetaxel/carboplatin, weekly docetaxel, docetaxel/briplatin and Gemcitabin/Irinotecan between four months. In 30 months after diagnosis, complete blood count showed hemoglobin 7.7 g/dl; white cell count 4,310/μl; and platelet 7.9×104/μl. A bone marrow examination revealed MDS. She then decided against further chemotherapy, opting instead for palliative care. Fortunately, up to the present, she has not developed AML.
Therapeutic procedure
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Chemotherapy-Oncologic Procedure
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Carboplatin
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Ovarian Cancer
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L
4.Measures Taken by Chemotherapy Center for Patients Discharged from Hospital to Share Information About Treatment
Journal of the Japanese Association of Rural Medicine 2007;56(6):863-867
Having provided chemotherapy at its outpatients clinics since 2002, the Saku Central Hospital in February 2006 established a Chemotherapy Center for Patients Discharged from Hospital. At this center, pharmacists check doctors' prescriptions, review all medications patients have been taking and dispense the prescriptions in a sterilized state. In addition, they are assigned on a daily basis to collect information on, and give guidance to, the patients. At the outpatient clinics, the length of time that can be set aside for the tabulation of information from patients' case records and for contact with the patients is inevitably likited. Given this situation, we began case study meetings in order to share information about patients between pharmacists in charge of guidance on the control of drugs at the time of their hospitalization and those who are in charge of chemotherapy at the Center. Later, these case study meetings were joined by physicians and nurses who thought it necessary to share information, thus leading to the establishment of a Conference at the Center. At this conference, pharmacists introduce information about patients at the time of their hospital admission and a discussion begins with the participation of various hospital staff members to solve given problems. By so doing, it has become possible to come to grips with the conditions of inpatients, enabling us to shift to services at the Center smoothly and give proper guidance when a medication produces undesirable effects. We consider the Conference signifies a step forward to the practice of medical care by teams.
Central
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Hospitals
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Chemotherapy-Oncologic Procedure
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Information
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Therapeutic procedure
5.Study on Effective and Safe Cancer Chemotherapy for Outpatients (Part1): Influence of Establishment of the Outpatient Cancer Chemotherapy Unit on Effective Usage of Hospital Beds
Eiji YONEYAMA ; Satoru MASE ; Hiroshi YOSHIDA ; Yuji OHIRA ; Hironobu NIINOMI ; Kazuhisa TSUZUKI ; Mizuho MURAKOSHI ; Kazuyuki NAKAMURA ; Makiko ARAI ; Kazuhisa SAWADA ; Akio KATSUMI
Journal of the Japanese Association of Rural Medicine 2008;57(1):1-7
Although the Outpatient Cancer Chemotherapy (OCC) Unit was established with in Anjo-Kosei Hospital in 2006, its real worth remains to be elucidated. To address this, the following subjects were examined;effective usage of hospital beds changes in the number of outpatients given to chemotherapy, length of hospitalization, the number of patients transferred by ambulance to the hospital, hospital occupancy rate, and the number of frequently used chemotherapy regimens.Since the establishment of the OCC Unit, the number of patients transferred by ambulance has increased and length of hospitalization has gradually decreased, accompanied by the increase in the number of outpatients treated at the OCC Unit. Additionally, no significant change was observed in the hospital occupancy rate. Furthermore, of the frequently used chemotherapy regimens, nine regimens were available for 62.4% of the total number of outpatients of the OCC Unit.These results indicated the useful effect of the establishment of the OCC Unit on the usage of hospital beds, and provided significant information helpful in promoting the effective and safe chemotherapy for outpatients in the OCC Unit.
Chemotherapy-Oncologic Procedure
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Unit
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seconds
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Outpatients
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Malignant Neoplasms
6.Severe Hemolytic Uremic Syndrome Associated with Cisplatin-based Chemotherapy for Advanced Bladder Cancer
Taku Naiki ; Satoshi Ishikawa ; Hideyuki Kamisawa ; Toshiki Kato ; Hidetoshi Akita ; Takehiko Okamura
Journal of Rural Medicine 2007;3(2):37-40
Hemolytic uremic syndrome (HUS) is a heterogeneous disorder characterized by hemolytic anemia, thrombocytopenia and renal failure that occurs predominantly in infants and young children. However, HUS in adults has also been described as a complication of various chemotherapy regimens with a relatively poor prognosis. Since cisplatin is now widely used for treatment of solid cancers, it is necessary to take into account the possibility of cisplatin-induced hemolytic uremic syndrome as a rare but potentially fatal side- effect. Herein, we describe our experience with a 67-year old woman being treated for a urothelial carcinoma of the bladder who suffered chemotherapy-induced HUS after a cisplatin-based regimen. Plasmapheresis was carried out five times; however, her serum platelets remained depressed, and she subsequently died. We conclude that there is a high risk potential for HUS in patients undergoing intensive chemotherapy for advanced-stage bladder cancer.
Hemolytic-Uremic Syndrome
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Chemotherapy-Oncologic Procedure
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Cisplatin
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Cancer of Bladder
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regimen
8.Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia.
Zarina Latiff ; S Z Zulkifli ; Rahman Jamal
The Malaysian journal of pathology 2002;24(2):83-9
Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64%), gram positive bacteria (16%) and fungus (20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta-lactamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.
Fever
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Neutropenia
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Malignant Neoplasms
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Chemotherapy-Oncologic Procedure
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majority
9.Surgical management of spinal tuberculosis in Papua New Guinea.
W Matui Kaptigau ; J B Koiri ; Isi H Kevau ; J V Rosenfeld
Papua and New Guinea medical journal 2007;50(1-2):25-32
Two cases of spinal tuberculosis (TB) presented with deteriorating myelopathy despite chemotherapy. Surgery of anterior decompression and fusion was successfully carried out resulting in both the patients ambulating and being continent on discharge. This highlights the importance of early surgery and a multidisciplinary approach to the management of this condition.
Surgical aspects
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Tuberculosis
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Papua New Guinea
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Chemotherapy-Oncologic Procedure
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Transmitted by
10.Evaluation of Quality of Life in Patients with Breast Cancer Treated with Chemotherapy
Takayuki KUGA ; Masatoshi SHIGETA ; Manabu SUDO ; Akimasa YAMASHITA ; Tomita NAKAYAMA ; Yasuhiro FUJII
Journal of the Japanese Association of Rural Medicine 2005;54(4):655-660
Recently the evaluation of health-related quality of life (QOL) in cancer patients has become important in carrying out a treatment strategy. During a period between June and August 2004, we studied the QOL in 16 breast cancer patients with or without chemotherapy. The regimens of chemotherapy were EC (n=6), AT (n=1) and CMF (n=1). We made the Functional Assessment of Cancer Therapy Scale-General (FACT-G) in all patients. The patients treated without chemotherapy were superior to those with chemotherapy with respect to physical and emotional well-being (p<0.05). There were no differences in social well-being and relationship to families between the two groups. The patients treated without chemotherapy made significantly higher scores in the basic activities of daily living than those with chemotherapy (p<0.05). Compared with patients receiving chemotherapy, patients treated without chemotherapy had better quality of life (p<0.05). We concluded that it was important for us to assist in decision making about treatment and supportive care needs.
Chemotherapy-Oncologic Procedure
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lower case pea
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Lower case en
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Malignant neoplasm of breast
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Pulmonary evaluation