http://hdl.handle.net/10564/4032 2021-12 2026-04-09T04:02:01Z http://hdl.handle.net/10564/4035 タイトル: Prevention of Recidivism Support for Community-Dwelling Forensic Patients: Assessment Items for Changes in The Patient's Condition Preceding The Appearance of Symptoms Developed in The Patient-Nurse Relationship. 著者: Okuda, Jun 抄録: Prevention of recidivism in community-dwelling forensic patients is an important task for nurses. This study aimed to clarify how assessment items for change in the patient's condition are developed between patients and nurses. It also aimed to clarify assessment items for changes in patients preceding the appearance of symptoms that lead to offending behavior. The processes in the development of assessment items for changes in the patient's condition in the patient-nurse relationship were: "Evaluation of assessment items between patients and nurses", "patient-initiated assessment", and "sharing of assessment results between patients and nurses". The assessment items for changes in the patient's condition were "changes compared with usual life", "identification of difficulties in the patients' lives", and "identification of factors that trigger symptoms". 2021-11-29T15:00:00Z http://hdl.handle.net/10564/4034 タイトル: 奈良県の高齢化地域におけるボノプラザンを用いたヘリコバクター・ピロリ除菌に関する検討 著者: 瓦谷, 英人; 久保, 卓也; 簗瀬, 公嗣; 藤本, 優樹; 中上, 純子; 小林, 正尚; 丸山, 直樹; 前川, 勝英; 松倉, 康夫; 松島, 俊裕; 吉治, 仁志; 西尾, 健治 抄録: Introduction: There are few reports on the efficacy and safety of vonoprazan (P-CAB) based triple eradication therapy in the elderly. In this study, we investigated the efficacy and safety of P-CAB based eradication of Helicobacter pylori (H. pylori) in non-elderly and elderly patients in our community, where the elderly population is high (41.7%). Methods: 205 patients who underwent primary and secondary eradication for H. pylori at our hospital from October 2018 to December 2020, were included in this study. Results: In primary eradication, the success rate for eradication in non-elderly and elderly patients was 96.6% (57 of 59 patients) and 88.7% (110 of 124 patients) respectively (P=0.10). The success rate for eradication in the late-elderly was 90.2% (46 of 51 patients). There was no significant difference compared with non-elderly patients (P = 0.25). The success rates for secondary eradication in non-elderly and elderly patients were 100% (7 of 7 patients) and 66.7% (10 of 15 patients). respectively, with no significant difference between the two groups (P = 0.13). The success rate for eradication in the late-elderly was low (40.0%: 2 of 5 cases). and there was significant difference compared with that in the non-elderly (P < 0.05). In the primary eradication, there was only one case of death from other diseases in the late-elderly patients during the first week after treatment. Discussion: In the elderly, the efficacy of primary eradication was similar to that for the non-elderly, and the frequency of incidental disease was low. Although the efficacy of secondary eradication was lower in the elderly, it was a safe treatment. 2021-11-29T15:00:00Z http://hdl.handle.net/10564/4033 タイトル: 表紙、目次、総目次、投稿規程詳細、奥付 (Vol.72 No.4,5,6) 2021-11-29T15:00:00Z http://hdl.handle.net/10564/4030 タイトル: The impact of toxigenic culture on antimicrobial prescriptions for Clostridioides difficile infection: The role of diagnostic stewardship. 著者: Sang-Tae, Lee; Tanaka, Shinobu; Yamazaki, Masaharu; Inoue, Takashi; Kasahara, Kei 抄録: Introduction : Toxigenic culture has been recommended as a sensitivity enhancement option for testing Clostridioides difficile infections (CDI). However, no studies have evaluated whether toxigenic culture impacts clinical decisions such as CDI treatment. Methods : At Nara Medical University Hospital, simultaneous testing of glutamate dehydrogenase antigen (A) and toxin A/B (T) by immunochromatography has been conducted since November 2013. Furthermore, toxigenic culture (C) has been adopted since April 2018. Therefore, patients tested for CD were divided into two groups: pre-period from April 2014 to March 2018 and post-period from April 2018 to March 2021. Patient data were retrospectively examined. Results : The study included 1262 and 1023 cases in the pre- and post-periods, respectively. A significant reduction in A+T+ cases could be observed with 64 (5.1 %) and 28 (2.7%) in the pre- and post-periods (P = 0.005), respectively. Of the 104 A+T- cases undergoing toxigenic culture in the post-period, 54 (51.9 %) were A+T-C+. The antimicrobial administration ratio for the A+T-C+ cases (68.5 %) was lower than that for the A+T+ patients (90.6 and 82.1 %, P = 0.014 and P = 0.417, in the pre- and post-periods, respectively), and was not significantly different from that of the A+T-patients (64.2 and 64.1 % in the pre- and post-periods, respectively) or from that of the A+ T-C-patients (64 %). Conclusion : This study showed that toxigenic culture does not necessarily affect the antibiotic administration ratio or duration. A coordinated approach under diagnostic stewardship for improved reporting and interpretation of toxigenic cultures would be necessary. 内容記述: 博士（医学）・乙第1525号・令和4年3月15日 2021-11-29T15:00:00Z