1.Preventing Surgical Site Infection in Cardiovascular Surgery : Cooperation between the Infection Control Team and Surgeons
Yu Shomura ; Yukikatsu Okada ; Noriko Shinkai ; Michihiro Nasu ; Hiroshi Fujiwara ; Tadaaki Koyama ; Mitsuru Yuzaki ; Takashi Murashita ; Naoto Fukunaga ; Yasunobu Konishi
Japanese Journal of Cardiovascular Surgery 2013;42(5):377-383
Postoperative infections should be comprehensively controlled in the context of infection control, rather than as activities of individual surgeons. We started a surgical site infection (SSI) surveillance program in 2009 in which prophylactic measures for preventing SSIs were applied. These measures were as follows : 1) screening for nasal carriage of methicillin-resistant Staphylococcus aureus ; 2) dental checks and oral screening ; 3) antibiotic prophylaxis in the intra- and postoperative period ; 4) control of glucose levels to ≤160 mg/dl in the immediate postoperative period ; and 5) early removal of surgical drain. After the introduction of prophylactic measures, we reexamined SSI surveillance and added the following prophylactic measures at the beginning of 2011 : 6) data concerning SSI and compliance with prophylactic measures for all surgical and ward staff were published monthly, and the Infection Control Team (ICT) and surgeons performed weekly ward visits to assess SSIs ; 7) recommendations were made for wearing two pairs of gloves and surgical hoods to cover the hair, scalp, ears and neck ; and 8) collaboration with diabetologists was implemented to control glucose levels in diabetics. We compared incidences of SSI in cardiovascular surgery from the periods before (469 cases, Group B) and after (118 cases, Group A) introduction of the additional prophylactic measures. Clinical characteristics of patients in each group did not differ significantly. Operative time was significantly shorter in Group A (400±116 min) than in Group B (434±145 min). Compliance with antibiotic prophylaxis in the intraoperative period improved progressively from 93% in Group B to 99% in Group A. Compliance with control of glucose levels to ≤160 mg/dl on postoperative day 1 improved progressively from 71% in Group B to 81% in Group A. Duration of drain placement was significantly shorter in Group A (2.9±1.8 days) than in Group B (3.6±2.9 days). Incidence of SSI decreased significantly from 6.0% in Group B to 0.8% in Group A. Revision of preventive measures based on the results of surveillance and enhancement of cooperation between the ICT and surgeons could help to decrease the incidence of SSI.
2.The Asia-Pacific Gynecologic Oncology Trials Group (APGOT): building a Pan-Asian and Oceania women’s cancer research organization
David TAN ; Noriko FUJIWARA ; Keiichi FUJIWARA ; Philip BEALE ; Jae-Weon KIM ; Joseph NG ; Se Ik KIM ; Alison EVANS ; Byoung-Gie KIM ;
Journal of Gynecologic Oncology 2023;34(2):e33-
3.Acupuncture Therapy for Hypertension (I)
Terukazu UCHIDA ; Hideo FUJIWARA ; Toshiaki IMOTO ; Shigeki OKADA ; Keiko NAKAYAMA ; Hiromasa INOUE ; Noriko MAEDA ; Shinya ABE ; Sei FURUTANI ; Yoshitomo SHIOAKI ; Naohide KOBAYASHI ; Futomi KOSAKA
Journal of the Japan Society of Acupuncture and Moxibustion 1982;32(1):54-58
Introduction
Essential hypertension is one of the leading causes of hypertension; responsible for more than 90% of such cases. Diet cure or drug treatment are usually prescribed for this disease. We drew notice to the antihypertensive effects of acupuncture.
Method
Subjects were healthy persons as well as patients complainig of simple essential hypertension. According to the WHO method, they were divided into three groups, e. g. normal, limitaneus, hypertensive. In situ needles were inserted in the antihypertensive points of both auricular sides for one week.
Effect
This treatment gave immediate results in 70% of the limitaneus and hypertensive groups. There was no observable effect for the balance. A number of these subjects were obese; a factor to be considered.
Evaluation
This method is very uncomplex and takes but minimal amount of time to treat patients.