1.Risk Factors for Surgical Site Infection (SSI) after Urological Surgery: Incisional and Deep-organ/space Experience at Anjo Hospital
Jun Sawai ; Takehiko Okamura ; Taku Naiki ; Yasuhiro Hijikata ; Hideyuki Oe ; Masashi Sawa ; Miyuki Hyodo ; Rie Inatomi ; Masami Okudaira ; Atsushi Naito ; Kazuhisa Inuzuka
Journal of Rural Medicine 2008;4(2):59-63
Objective: In urological operations, many endourological procedures and pre-existing urinary tract infections may cause surgical complications. It is essential to identify the risk factors for surgical site infections (SSI) and determine additional influences. Patients and Methods: In the present retrospective investigation, a total of 324 patients who underwent open urological surgery between January 2003 and December 2007 at Anjo-Kosei Hospital were assessed for SSI along with possible associated factors. Results: Forty-four cases (13.6%) proved positive for SSIs during the surveillance period. Among these, 31 demonstrated incisional SSI and 13 demonstrated deep/organ space SSI. Greater age and body mass index, low preoperative haemoglobin levels, long preoperative hospital stay, prolonged operation time and increased blood loss during surgery were all positively associated with SSI in general. For the deep/organ space SSI cases, advanced age, low preoperative haemoglobin levels, long preoperative hospital stay and prolonged operation time were significant factors. Conclusion: This study identified several independent predictors of SSI in general, as well as deep/organ space infection, for urological open surgery at our hospital. The results provided a basis for urologists to decrease the incidence of urological SSI.
Surgical aspects
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Hospitals
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Organ
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Infection as complication of medical care
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Risk Factors
2.Clinical Features and Treatment Outcome of Childhood Leukemia
Yuji MIYAJIMA ; Erika KITAMURA ; Yoko SHIBATA ; Chihiro HATANO ; Fumiko MIYAZAKI ; Sachie ITO ; Jun SAWAI ; Miyuki MAGOTA ; Kaname MATSUSAWA ; Tatsuya FUKAZAWA ; Koji TAKEMOTO ; Tetsuo KUBOTA ; Yuichi KATO ; Akimasa OGAWA ; Kuniyoshi KUNO
Journal of the Japanese Association of Rural Medicine 2011;60(4):527-534
We reviewed the clinical features and treatment outcome of 110 children with leukemia. Treatment was performed between 1980 and 2009 at our hospital. The mean age at onest was 5 years 6 months, the ratio of males to females was 1:0.72, and mean leukocyte count was 4.91×104/μl. Subtypes of leukemia were acute lymphoblastic leukemia (ALL) in 79.1% of the patients, acute myeloid leukemia (AML) in 17.2%, and chronic leukemia in 3.6%. In all patients, the overall 30-year survival rate estimated by the Kaplan-Meier method was 67.4%. In the three decades from the 1980s, the overall 10-year survival rate has been improved significantly from 46.4% in the 1980s, 69.2% in the 1990s to 87.2% in the 2000s (P<0.01). The overall 10-year survival rate was 70.7% in all children with ALL, and 70.6% in all children with AML. But in the last decade, the 10-year survival rate was improved to 87.0% in children with ALL and 87.3% in children with AML. Twenty-four patients received hematopoietic stem-cell transplantation, and the 10-year survival rate was 58.6% after transplant. Second malignancies were detected in three patients, and six patients have long-term sequelae. In conclusionn, the treatment result of childhood leukemia has improved considerably, so that more intensive treatment for patients with poor prognosis and less toxic treatment for patients with good prognosis will be necessary in future.