2.Ultrasound-guided rectus sheath block for improvement of feelings of abdominal distension
Kaoru Nishijima ; Norio Hashimoto ; Miwako Kobayashi ; Takako Morimoto ; Noriko Sakaguchi ; Akiko Nakanishi ; Yuko Tanaka ; Fumiko Koyama ; Shinichiro Zushi ; Kunitaka Shibata
Palliative Care Research 2012;7(1):526-529
We report a case in which feelings of abdominal distension and discomfort of the abdominal wall caused by malignant ascites were relieved by ultrasound-guided rectus sheath block. Case report: A 59-year-old man developed gastric cancer with malignant ascites and experienced feelings of abdominal distension, but no nausea, dyspnea, poor mobility, or limb edema. Symptom control was inadequate with diuretic therapy and abdominal paracentesis. Feelings of distension improved temporarily with ultrasound-guided rectus sheath block. A percutaneous catheter was then used to administer an infusion of 0.25% ropivacaine triweekly until his death 20 days later. Conclusion: Feelings of abdominal distension is one of various symptoms of severe ascites and is difficult to manage. Ultrasound-guided rectus sheath block can be used to relieve this symptom on a case-by-case basis.
3.Successful elimination of intractable lower limb neuropathic pain by pelvic tumor invasion using ultrasound-guided sciatic nerve block
Norio Hashimoto ; Kaoru Nishijima ; Miwako Kobayashi ; Chieko Kuwahara ; Takako Morimoto ; Noriko Sakaguchi ; Akiko Nakanishi ; Yuko Tanaka ; Fumiko Koyama ; Shinichiro Zushi ; Kunitaka Shibata
Palliative Care Research 2010;6(1):313-315
We report a case whose left lower limb neuropathic pain accompanied by pelvic tumor invasion was remarkably eliminated by ultrasound-guided sciatic nerve block. Case report: The subject was a sixty year old male. Pharmacological therapy was given according to the WHO analgesic ladder, but his left lower limb pain failed to respond to drugs. His intractable lower limb neuropathic pain was alleviated by ultrasound-guided sciatic nerve block. Drug delivery can be achieved with a percutaneous catheter and a disposable infusion pump. Infusions were run at 5mlh-1 with 0.1% ropivacaine. Conclusion: Neuropahic pain is sometimes hard to be controlled only by opioids or adjuvant analgesics, but there is a possibility of providing pain relief by combination use with nerve blocks. Interventional techniques can be highly effective but also have the potentiality to produce significant adverse effects. Many patients have factors which would be considered a near absolute contra-indication to the use of nerve blocks such as immuno-compromise or impairment of coagulation. Skillful application of peripheral neural blockade with ultrasound imaging broadens the options for providing optimal pain management. Palliat Care Res 2011; 6(1): 313-315
4.Investigation of Dispensed Medicines That Can Affect the Recognition Function of Elderly Patients at a Community Pharmacy Located in a Satellite City
Yuko SAKAGUCHI ; Hana HIRAI ; Risa KITAGAWA ; Yugo KOIKE ; Takuya MASAKI ; Masayuki YOKOI ; Yuko YOKOI ; Nobuhiro ICHIKAWA
Japanese Journal of Social Pharmacy 2022;41(1):37-44
Introduction: This study aimed to determine the trends in the use of medicines that can affect the recognition function of patients aged ≧70 years. Since 2015 when the “Safe Drug Treatment Guidelines for the Elderly” was revised, these medicines are dispensed at a community pharmacy located in a satellite city. Methods: We compared the dispensing results from 2014 to 2015-2019 and investigated the ratio of prescriptions containing the medicines that can affect the recognition function using the clinical department and medicine type. Results: Prescriptions containing medicines that can affect recognition function have been on a downward trend since 2015. During this period, the number of medicines per prescription did not decrease, and the medicines that can affect recognition function were replaced with other medicines. On the other hand, no decrease in the number of medicines that can affect recognition function was observed in internal medicine. In medicine type, the ratio of benzodiazepines drugs decreased; however, it increased again in 2019. Conclusion: There was a decreasing trend in the use of medicines that can affect recognition function of the elderly in departments other than internal medicine after 2015.
5.Clinical meaning of sarcopenia in patients undergoing endoscopic treatment
Hiroyuki HISADA ; Yosuke TSUJI ; Hikaru KURIBARA ; Ryohei MIYATA ; Kaori OSHIO ; Satoru MIZUTANI ; Hideki NAKAGAWA ; Rina CHO ; Nobuyuki SAKUMA ; Yuko MIURA ; Hiroya MIZUTANI ; Daisuke OHKI ; Seiichi YAKABI ; Yu TAKAHASHI ; Yoshiki SAKAGUCHI ; Naomi KAKUSHIMA ; Nobutake YAMAMICHI ; Mitsuhiro FUJISHIRO
Clinical Endoscopy 2024;57(4):446-453
With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.