1.Construction and Evaluation of an Outpatient Prescription Discrimination System Using GeneralPurpose Database Software
Toru Kawagishi ; Masayoshi Kumai ; Yumiko Osaki ; Rika Shinzato ; Masami Kiyokawa ; Sachiko Harada ; Kumiko Kasashi ; Toshitaka Fukai ; Takehiro Yamada ; Ken Iseki
Japanese Journal of Drug Informatics 2011;13(3):103-112
Objective: It is very important that, to avoid, pharmacists-check medication being taken by patient. In the Hokkaido University Hospital we used commercial drug identification software at the start of outpatient prescription identification duty and reported the outcome. Furthermore, we filled in another hand-written check sheet with the drug’s name, whether or not it is used in our hospital, alternative drugs, and the dosage and administration. Because of the risk of drugs being entered by mistake, we built a database for drug identification and distinguished the outpatient’s prescriptions. With this system it is possible integrate identification reports and check sheet using one style, automatically. We also to smoothly rationalize duties by planning correct communication between the medical staff. At the same time, we analyzed the case that was able to intervene in reasonable use of medical supplies with a past identification report as a result of pharmacists distinguishing outpatient prescriptions.
Design and Methods: This system was constructed using Microsoft® Access, which is a general-purpose database software. Also, the medical supply database that we used for this system uses “Drugs in Japan Ethical Drugs DB (supervised by Drugs in Japan Forum)” published by JIHO Co., Ltd.
Results: By using this system, we were able to reduce the time required to identify the drugs and make the report. The result of a questionnaire carried out on doctors and a nurses and medical staff revealed that more than 90% of the respondents claimed, “the report is easy to refer.” Likewise, we analyzed a report of the previous year and recognized that medical staff could not find the inappropriate use of prescriptions for outpatients in about 17.5%.
Conclusion: This system improved the efficiency of outpatient prescriptions practices, and it became clear that it could be used convincingly as a tool to share appropriate drug information between medical staff and pharmacists, more precisely. In addition, feedback from medical staff suggested that it might prevent the risk of problems surrounding outpatient prescriptions, from the viewpoint of the pharmacist.
2.Estimation of Exercise Intensity and Ramp Load in Cardiopulmonary Exercise Testing Using the Maximum Walking Speed in Elderly Hospitalized Patients with Acute Coronary Syndrome
Hiroaki TATSUKI ; Yasuhiro NOMA ; Masashi KAWABATA ; Tomoko KAWAHARA ; Daichi NAOI ; Ryo SHIMADA ; Kazuhiro MIBU ; Toru AIZAWA ; Harukazu ISEKI
Journal of the Japanese Association of Rural Medicine 2016;65(2):202-214
This study investigated data on cardiopulmonary exercise testing (CPX) indices in order to estimate exercise intensity and ramp load from maximum walking speed (MWS) in elderly hospitalized patients with acute coronary syndrome (ACS). Subjects were 66 male patients hospitalized with ACS (49 young-old patients and 17 old-old patients). We measured exercise intensity by CPX using a cycle ergometer and MWS over 10 m, and examined the patients’ clinical characteristics. Stepwise multiple regression analysis was performed to identify variables that most closely predicted exercise intensity. We then estimated the ramp load from the relationship between exercise load at anaerobic threshold and MWS. The results indicated that MWS was an independent predictor of exercise intensity in old-old patients (adjusted R2=0.278, p=0.037) but not in young-old patients. The regression formula predicted the proper ramp load to be 5 and 10 watts as MWS was less than 1.5m/s or more than 1.5m/s, respectively. MWS was related to exercise intensity and could be used to consider the ramp load in CPX in old-old male patients with ACS.
3.Clinical Background and Hospitalization Progress in Patients with Acute Myocardial Infarction Who Experienced Cardiac Rehabilitation
Hiroaki TATSUKI ; Yasuhiro NOMA ; Tomoko KAWAHARA ; Masashi KAWABATA ; Toru AIZAWA ; Atsushi MATSUZAKI ; Yasunari HOSHIBA ; Tatsuya SUGIHARA ; Yota KAWAMURA ; Daiki ITO ; Harukazu ISEKI
Journal of the Japanese Association of Rural Medicine 2012;61(1):16-26
Purpose: To compare the effects of aging in patients with acute myocardial infarction (AMI) on their clinical background and hospitalization progress, and to examine the relationships between age and these factors.
Subject: One hundred and fifty-three patients who experienced cardiac rehabilitation after percutaneous coronary intervention (PCI) (63.8±11.1 y.o, 126 men, 27 women).
Method: The patients were divided into the middle aged group (<65 y.o, n=84), young old group (65 to 74 y.o, n=44), and old group (75 y.o≥ n=25). The differences between groups were examined in respect of 13 items about clinical backgrounds (responsibility coronary arteries, CKmax, LVEF, residual stenosis, hypertension, diabetes, hyperlipemia, smoking, and BMI) and hospitalization progress (cardiac complications, locomotorium disabilities, abnormality as 200mECG, and duration of hospitalization).
Results: Left veticular ejection fraction (LVEF) was significantly lower in the old group than in the young old group. The old group had a high rate of residual stenosis. In the coronary risk factors, all of the groups had hypertension at a high rate of 54.5% or over. The middle aged group and young old group had diabetes at about 38%. The middle aged group was prone to hyperlipemia, and had significantly a high smoking rate. Body mass index (BMI) was significantly higher in the middle aged group than in the old group. In hospitalization progress, the old group had a high rate of cardiac complications and locomotorium disability. The duration of hospitalization was significantly longer in the old group than in the other groups.
Conclusion: It would be necessary to give middle-aged persons educational guidance for the improvement of the coronary risk factors, and to provide the old persons with the suitable rehabilitation programs considering various complications.
4.Freeze-Dried Human Platelet-Rich Plasma Retains Activation and Growth Factor Expression after an Eight-Week Preservation Period.
Yasuhiro SHIGA ; Go KUBOTA ; Sumihisa ORITA ; Kazuhide INAGE ; Hiroto KAMODA ; Masaomi YAMASHITA ; Toru ISEKI ; Michihiro ITO ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Koki ABE ; Hirohito KANAMOTO ; Masahiro INOUE ; Hideyuki KINOSHITA ; Takeo FURUYA ; Masao KODA ; Yasuchika AOKI ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2017;11(3):329-336
STUDY DESIGN: Controlled laboratory study. PURPOSE: This study aimed to evaluate the efficacy of platelet-rich plasma (PRP) stored at room temperature (RT), frozen, or after freeze-drying. OVERVIEW OF LITERATURE: PRP enriches tissue repair and regeneration, and is a novel treatment option for musculoskeletal pathologies. However, whether biological activity is preserved during PRP storage remains uncertain. METHODS: PRP was prepared from blood of 12 healthy human volunteers (200 mL/person) and stored using three methods: PRP was stored at RT with shaking, PRP was frozen and stored at −80℃, or PRP was freeze-dried and stored at RT. Platelet counts and growth factor content were examined immediately after preparation, as well as 2, 4, and 8 weeks after storage. Platelet activation rate was quantified by flow cytometry. RESULTS: Platelet counts were impossible to determine in many RT samples after 2 weeks, but they remained at constant levels in frozen and freeze-dried samples, even after 8 weeks of storage. Flow cytometry showed approximately 80% activation of the platelets regardless of storage conditions. Almost no growth factors were detected in the RT samples after 8 weeks, while low but significant expression was detected in the frozen and freeze-dried PRP. Over time, the mean relative concentrations of various growth factors decreased significantly or disappeared in the RT group. In the frozen group, levels were maintained for 4 weeks, but decreased significantly by 8 weeks (p <0.05). The freeze-dried group maintained baseline levels of growth factors for the entire 8-week duration. CONCLUSIONS: Freeze-drying enables PRP storage while maintaining bioactivity and efficacy for extended periods.
Blood Preservation
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Flow Cytometry
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Freeze Drying
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Healthy Volunteers
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Humans*
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Intercellular Signaling Peptides and Proteins
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Pathology
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Platelet Activation
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Platelet Count
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Platelet-Rich Plasma*
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Regeneration