BackgroundMedication self-management in stroke patients is important to prevent further progression of disease and incidence of side effects. The purpose of this study was to create a formula for predicting medication self-management introduction in stroke patients using functional independence measure items and patient data, including medication-related information.MethodsThis was a retrospective analysis of 104 patients (cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage) discharged from the Kaifukuki rehabilitation ward at Showa University Fujigaoka Rehabilitation Hospital from January to December 2012. Multivariate analysis was performed to develop a formula for predicting achievement of medication self-management.ResultsOf the 104 patients, 39 (37.5%) achieved medication self-management. In the logistic regression analysis, number of drugs, age, walk/wheelchair mobility FIM, and memory FIM were extracted as significant factors independently contributing to achievement of medication self-management (p < 0.05). The prediction formula was [4.404 − 0.229 × number of drugs at admission + 0.470 × walk/wheelchair mobility FIM at admission + 0.416 × memory FIM at admission − 0.112 × age].ConclusionsIn the future, this formula may be used as an index to predict success of medication self-management in stroke patients.
Intraperitoneal administration of 2,5-dimethylpyrazine (2,5-DMP) was found to inhibit oxytocin- and prostaglandin F2alpha-induced tetanic uterine contractions in normal or pregnant female rats. This suggests that 2,5-DMP may be used as a countercontraction agent or relaxant for preventing oxytocic agent-induced medical accident including uterine rupture or pressure death of the fetus due to uterine contractions.
This study investigated the required duties of pharmacists in a kaifukuki rehabilitation ward from the viewpoint of the ward physicians and nurses. A questionnaire survey was distributed to 27 facilities with kaifukuki rehabilitation wards. The questionnaire examined which duties the physicians and nurses expected from pharmacists while on the ward (4 areas, 10 items), as well as the time required for pharmacists to carry out those duties. Multivariate analysis was used to investigate which types of work took the most time for pharmacists on kaifukuki rehabilitation wards. Responses were received from 43 physicians and 184 nurses who worked on the kaifukuki rehabilitation wards of 19 facilities. The results revealed that the essential duties performed by pharmacists were the management of medical supplies, instruction on the use of self-medicating drugs at the time of introduction, and monitoring drug side effects. Furthermore, some duties, such as the distribution of medicines and changing or suggesting new drugs, required pharmacists to spend extended time on the ward. The responses indicated that physicians and nurses recognized the necessity for pharmacists to perform ward duties along with their routine work. This study shows that physicians and nurses working in kaifukuki rehabilitation wards demand proactive participation from pharmacists in appropriate medical therapy, such as instruction in the administration of medications and assessment at the time of prescription changes.
Effect of 2,5-dimethylpyrazine (2,5-DMP) on oxytocic agent-induced late pregnant uterine contraction in female rats was studied. Oxytocic agents induced-hypercontraction in the late phase of pregnant uterine movements were inhibited by administration of 2,5-DMP. The inhibition of uterine contraction was obtained more strengthening by presence of a low dose of ritodrine hydrochloride than 2,5-DMP alone. These results suggests that 2,5-DMP has an inhibitory action on uterine hypercontraction induced by oxytocic agent through the b b 2 -adrenoceptor in the pregnant uterus and supports the appllicability of relaxing drugs for oxytocic agent-induced accidents.
Azithromycin AZM injection tends to increase injection site pain when administered in excess of 2 mg / ml. As AZM is frequently used in combination therapies, it is expected to be administered at a high concentration in clinical use due to uid restrictions. Therefore, in this study, the relation between AZM concentration and injection site pain was examined. From January 2012 to July 2017, we retrospectively investigated the medical records of patients who were administered AZM by injection at Showa University Fujigaoka Hospital. Vascular pain was related to intensive care unit ICU administration P 0.003 compared with that in general wards and a long duration of administration P 0.002. The number of days of AZM injection should be kept as short as possible. Given that the risk of injection site pain is increased in the ICU, we recommend switching to oral administration. Further collection of safety data in patients on uid restriction is necessary, and high concentration AZM administration should be considered.
As antibiotic resistance has become a global problem, the intervention of an antimicrobial stewardship team (AST) is warranted. In hematological disorders, infectious complications are crucial owing to abnormal neutrophil function and decreased cell-mediated immunity. Despite the widespread implementation of AST intervention, the effectiveness of stewardship practices for immunocompromised patients remains uncertain. We determined the effect of AST interventions on carbapenem therapy in the department of hematology. Patients admitted to the department and undergoing carbapenem therapy were enrolled. We compared carbapenem use between the pre-AST (April 2016–March 2018) and post-AST (April 2018–March 2021) periods. Factors associated with long-term carbapenem therapy were investigated. Overall, 515 episodes of carbapenem therapy in 264 patients in the department were evaluated. According to the interrupted time series analysis, the number of days of therapy decreased with AST intervention (β = −0.263, p = 0.011). In multivariate analysis, predictive factors associated with long-term carbapenem therapy (>8 days) were outpatient onset, chronic obstructive pulmonary disease, acute myeloid leukemia, multiple myeloma, and infection with resistant bacteria (such as extended spectrum β-lactamases and AmpC) (95% confidence interval, 1.030–2.818, 1.067–66.667, 1.057–2.782, 0.168–0.742, and 1.382–5.750, respectively). The AST intervention reduced carbapenem use in patients with hematological disorders.
Objective: To elucidate the impact of cerebrovascular lesion location on patients' ability to manage their own medications, we retrospectively investigated the differences in ability between the left hemisphere damage group (Group L) and the right hemisphere damage group (Group R). Methods: In patients with cerebrovascular disease who were discharged from the Kaifukuki rehabilitation ward of our hospital between October 2011 and March 2013 and between January 2016 and December 2017, Group L and Group R were compared.
Results:The study subjects were 282 patients, and both Group L and Group R had 141 patients each. The length of time required for achieving medication selfmanagement was longer in Group L than in Group R (p = 0.02), showing a significant difference.
Conclusion:The delay in achieving medication selfmanagement in Group L was considered due to impairment of the dominant arm by right hemiplegia, which, unlike in Group R, hindered the dexterity required for taking medications. In order for patients with cerebrovascular disease to become capable of managing their own medications, it is considered essential to assist in developing medication support plans according to lesion location.
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