Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to thes...Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to these high prevalence rates,such as blood transfusions and length of dialysis time. Nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure is considered more important.Several prophylactic measures have been suggested to avoid infection by HCV in the HD environment.展开更多
In 2012-2013, CMH （Community Memorial Hospital） had a 10.5% 30-day readmission rate from SNFs （skilled nursing facilities）. The focus of the Connections of Care Coalition was to review the medication reconciliatio...In 2012-2013, CMH （Community Memorial Hospital） had a 10.5% 30-day readmission rate from SNFs （skilled nursing facilities）. The focus of the Connections of Care Coalition was to review the medication reconciliation process and to involve pharmacists in the transition of patients to SNFs. The objective of the project was to work as an interdisciplinary team to improve the communication during transitions of care from our hospital to local SNFs by identifying key issues and initiating pharmacy practice change. This quality improvement project had a pre-post study design. Patients older than 18 years of age discharged to SNFs and/or readmitted from SNFs within 30 days were included. Baseline data was collected, specific pharmacist interventions were identified, educated on and implemented, and post-implementation data was collected. The number of interventions made and documented by pharmacists for patients being discharged from CMH to local SNFs did not significantly change during this quality improvement study. Clinically significant interventions were made on high risk medications, such as warfarin. Finally, a newly redesigned SNF workflow was implemented to include pharmacy, nursing, social work/case management to improve patient care and safety for discharges to SNFs.展开更多
AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS:A retrospective analysis was performed on 4163 patients who underwent gastric resec...AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS:A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS:Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer(EGC)was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION:In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.展开更多
文摘Hepatitis C virus(HCV)infection is highly prevalent among patients on hemodialysis(HD).The prevalence of HCV infection in HD patients varies markedly from country to country.Some factors are especially related to these high prevalence rates,such as blood transfusions and length of dialysis time. Nosocomial routes of transmission including the use of contaminated equipment and patient-to-patient exposure is considered more important.Several prophylactic measures have been suggested to avoid infection by HCV in the HD environment.
文摘In 2012-2013, CMH （Community Memorial Hospital） had a 10.5% 30-day readmission rate from SNFs （skilled nursing facilities）. The focus of the Connections of Care Coalition was to review the medication reconciliation process and to involve pharmacists in the transition of patients to SNFs. The objective of the project was to work as an interdisciplinary team to improve the communication during transitions of care from our hospital to local SNFs by identifying key issues and initiating pharmacy practice change. This quality improvement project had a pre-post study design. Patients older than 18 years of age discharged to SNFs and/or readmitted from SNFs within 30 days were included. Baseline data was collected, specific pharmacist interventions were identified, educated on and implemented, and post-implementation data was collected. The number of interventions made and documented by pharmacists for patients being discharged from CMH to local SNFs did not significantly change during this quality improvement study. Clinically significant interventions were made on high risk medications, such as warfarin. Finally, a newly redesigned SNF workflow was implemented to include pharmacy, nursing, social work/case management to improve patient care and safety for discharges to SNFs.
基金Supported by Japanese Foundation for Multidisciplinary Treatment of Cancer
文摘AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS:A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS:Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer(EGC)was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION:In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.
