1.Characteristics of Social Work Support in Neonatal and Pediatrics Departments
Yuki ICHIKAWA ; Miho ISOZAKI ; Seiichi WATANABE ; Junichi SHIMIZU ; Akimitsu WATANABE
Journal of the Japanese Association of Rural Medicine 2015;64(1):29-33
We often experience difficulty supporting the pediatric social work because, under the present social welfare system, support services change as patients grow. Recently, studies aimed at establishing practice models have increased in the pediatric social work region. With a view to establishing practice models, we reviewed our experience in the neonatal and pediatrics departments. Our investigation found that almost all support requests in the neonatal cases were from our medical staff. For inpatients, request were mostly concerned with hospital discharge support. Requests in behalf of outpatients were consultation about physical examination. Most of the support processes ended up in liaison and coordination or providing information. In the pediatric department, the most common route of requests for inpatients was from our medical staff, but for outpatients, the requests came from public institutions and private facilities concerned. Most requests for inpatients were related to the use of the social welfare system. Meanwhile, requests in behalf of outpatients were centered on support of consultation about physical examination. From the above, we concluded that in the pediatric social work region, social workers should approach not only patients and their family members but also medical staff and community institutions. We deemed it necessary to coordinate social-welfare services based on a long-term plan, taking into account the growth of children.
2.Verification of selective and individual pulmonary thromboembolism prophylaxes for cesarean delivery
Ryuji KAWAGUCHI ; Tomoka MAEHANA ; Yuki YAMADA ; Mayuko ICHIKAWA ; Juria AKASAKA ; Fuminori KIMURA
Obstetrics & Gynecology Science 2023;66(3):181-189
Objective:
This study aimed to verify the utility of simple, safe, and effective venous thromboembolism (VTE) prophylaxis and implement it with few adverse events during cesarean delivery.
Methods:
This single-center, prospective study involved pregnant women who underwent cesarean deliveries from August 3, 2020 to March 31, 2022. Patients with VTE risk factors were initially administered unfractionated heparin (5,000 international unit [IU] subcutaneously, twice daily), 6 hours after cesarean delivery. Subsequently, they were administered enoxaparin (2,000 IU subcutaneously, twice daily). They were not administered anticoagulants if one or more of the exclusion criteria were met. The primary efficacy outcome was the incidence of symptomatic VTE. The primary safety outcome was the incidence of major bleeding.
Results:
Out of the 850 women eligible for this study, 551 (64.9%) had one or more VTE risk factors and 299 (35.1%) had no risk factors. Of the 551 women with one or more VTE risk factors, 15 met one or more exclusion criteria for enoxaparin administration. A total of 314 women received only perioperative mechanical prophylaxis, including 15 who met the exclusion criteria for anticoagulants and 299 without VTE risk factors. During implementation of the protocol, no woman developed symptomatic VTE after cesarean delivery. Major bleeding occurred in only one woman who received postoperative anticoagulants.
Conclusion
This protocol, which clarified the administration of anticoagulants according to VTE risk factors and dose reduction/discontinuation criteria, may be an effective and safe VTE prophylaxis for cesarean deliveries.
3.Long-term outcome after surgery in a patient with intestinal Behçet’s disease complicated by myelodysplastic syndrome and trisomy 8
Yuki MORI ; Fumihiko IWAMOTO ; Yasuaki ISHIDA ; Toru KUNO ; Shoji KOBAYASHI ; Takashi YOSHIDA ; Tatsuya YAMAGUCHI ; Tadashi SATO ; Makoto SUDO ; Daisuke ICHIKAWA ; Nobuyuki ENOMOTO
Intestinal Research 2020;18(4):469-475
Behçet’s disease (BD) is a multisystem inflammatory disease of unknown origin. Rarely, BD occurs together with myelodysplastic syndrome (MDS). Interestingly, it is speculated that these are not simple coexistence but that the etiology of intestinal BD is at least partly derived from MDS itself. Furthermore, there is a relationship between MDS in patients with intestinal BD and trisomy 8. Immunosuppressive agents alone are insufficient to control MDS-associated BD, and many of these patients die of infection or hemorrhage. Surgery is considered for intestinal BD patients who are unresponsive to medical treatment or those with bowel complications such as perforation or persistent bleeding. We report a case of intestinal BD associated with MDS and trisomy 8. The patient was unresponsive to oral steroids and immunosuppressive treatment; the patient improved by surgical repair of a bowel perforation. Five years after the surgery, the patient is free of recurrence and not on medication. Our experience suggests that surgery may provide an effective therapeutic option for the treatment of MDS-related BD.
4.Survey on Medical Residents' Attitudes Toward Conference Presentations
Hiroyuki SUGO ; Yuki SEKINE ; Ryosuke ICHIKAWA ; Shozo MIYANO ; Ikuo WATANOBE ; Michio MACHIDA ; Toshiaki KITABATAKE ; Yoshifumi LEE ; Kuniaki KOJIMA
Medical Education 2018;49(3):213-218
Introduction: Conference presentations are a very instructive experience for doctors.Aim: The aim of this study was to evaluate residents' attitude toward conference presentations.Methods: A questionnaire-based survey was conducted on 22 residents at our hospital, regarding their experience with giving a conference presentation.Results: Of the 22 residents, 15 (68%) completed the questionnaires. 13 (87%) of them had experienced giving a presentation for the first time. Overall, 14 (93%) of the 15 residents thought the experience of giving a conference presentation was very instructive. 12 residents (80%) wanted to experience it again. On the other hand, a few residents requested that giving a presentation be made voluntary and not mandatory.Conclusion: The results of our study demonstrates that giving conference presentations would be a very valuable experience for young doctors. The experience of giving a presentation coupled with prior explanations about its instructive value could positively impact intrinsic motivation.