Introduction:As prehospital care became emphasized in emergency medical services in Japan, qualification as a “paramedic” was established in 1991 as a requirement for national qualification as a emergency medical technician (EMT).With recent increases in emergency transportation, the responsibilities of paramedics have become more complex and demand a higher level of competency; however, no method of evaluating occupational stress among Japanese EMTs currently exists.Methods:A questionnaire survey of the working conditions and health of 2,017 EMTs in Hyogo Prefecture was conducted. To analyze stress levels among these EMTs, the survey was divided into two categories: (1) physical stress; and (2) mental stress.Results:The number of responses was 1,551 (76.9%) and the average age of the respondents was 35.4 years. The lower back, neck, and shoulders were most frequently subjected to physical stress, which was related to the daily operations as an EMT. Mental stress was reported more frequently by those who were older or qualified paramedics.Discussion:The high frequency of lower back pain suggests the need for improvement in the work environment and periodic education.Conclusions:Although job satisfaction among paramedics was high, they were exposed to greater mental stress. Therefore, systematic management of stress must be developed and established.
Photodynamic therapy (PDT) is a minimally invasive antitumor therapy that eradicates tumor cells through a photosensitizermediated cytotoxic effect upon light irradiation. However, systemic administration of photosensitizer often makes it difficult to avoid a photosensitive adverse effect. The red fluorescent protein KillerRed generates reactive oxygen species (ROS) upon green light irradiation. Here, we show the therapeutic potential of a novel tumor-specific replicating photodynamic viral agent (TelomeKiller) constructed using the human telomerase reverse transcriptase (hTERT) promoter. We investigated the lightinduced antitumor effect of TelomeKiller in several types of human cancer cell lines. Relative cell viability was investigated using an XTT assay. The in vivo antitumor effect was assessed using subcutaneous xenografted tumor and lymph node metastasis models. KillerRed accumulation resulted in ROS generation and apoptosis in light-irradiated cancer cells. Intratumoral injection of TelomeKiller efficiently delivered the KillerRed protein throughout the tumors and exhibited a long-lasting antitumor effect with repeated administration and light irradiation in mice. Moreover, intratumorally injected TelomeKiller could spread into the regional lymph node area and eliminate micrometastasis with limited-field laser irradiation. Our results suggest that KillerRed has great potential as a novel photosensitizer if delivered with a tumor-specific virus-mediated delivery system. TelomeKillerbased PDT is a promising antitumor strategy to efficiently eradicate tumor cells.
Case:In rare cases, spinal epidural abscess involves the entire spine and can lead to neurological deficits and sepsis if treatment is delayed or suboptimal. A 65-year-old man was admitted with a diagnosis of bacterial meningitis. After admission, magnetic resonance imaging showed a spinal epidural abscess from the cervical to lumbar spine. Blood culture revealed Staphylococcus aureus. The patient was initially treated medically because he had no neurological deficits. Repeat blood culture remained positive and abscesses were found in the mediastinum and bilateral psoas muscles.Outcome: Surgery was carried out and the patient's postoperative course was satisfactory. Conclusion: Spinal epidural abscess can extensively affect the spine and may present with the symptoms of bacterial meningitis. It is essential to examine the entire spine and paraspinal regions and to treat early in cases of spinal epidural abscess.
We report the changes that have occurred in the system for emergency medical responses after the Hanshin-Awaji Earthquake, and what we have learned from the emergency medical response following the Taiwan earthquake. In the Hanshin-Awaji earthquake, 5 years ago, we learned many lessons and are going to construct a new system of disaster medical response in Japan. What we learned about the excellent activities of emergency medical response were practiced in Taiwan following the earthquake of last September. Because the damages to the local governmental offices were limited, the unification of incident command was practiced, and many patients with severe injuries were transported out of disaster regions. Large quantities of medical equipment were transported into the disaster regions by the army. Many medical teams from non-disaster areas also were dispatched rapidly, for Taiwanese have good sense of self-defense for preventing disaster.We should make greater effort to construct a good system for the emergency medical response for the future disasters in Japan. It should include the rapid dispatch system for search and rescue teams with medical teams, a system for transporting the severely injured patients to the non-disaster areas through the core hospitals in disaster areas using helicopters, and the coordination of multiple agencies. The Taiwan earthquake measuring 7.3 on the Richter scale, struck at 01:47 hours on 21 September 1999, and resulted in the deaths of >2,000 people. Taipei, the capital city of Taiwan and 200 kilometers from the epicenter, sustained collapse of only one building (12-story) like a pile of stacked pancakes, but it resulted in the highest death toll among all collapsed structures in the quake.To characterize the management of urban, prehospital EMS transportation during a disaster, we surveyed the distribution of the patients by receiving hospitals and by the severity of the injured patients taken from this collapsed building. Seventy-six victims were dead upon extrication. All 138 patients who were extricated alive were distributed between seven surrounding general hospitals within a 15-minute distance for transportation. Among these, 74% (102/138) of patients were transported by EMS ambulance and 87% (89/102) were sent to the two most nearby hospitals within 5 minutes distance regardless their severity of injury. They arrived within 3 hours after the quake and resulted in overcrowded conditions in the two Emergency Departments. A diagram of the relation between the surrounding hospital distance, the number, and injury severity by distribution of the patients will be presented.Transportation management of this confined space disaster in urban area was overlooked. Though the distribution of general hospitals is compact in this prosperous city, the incident command system should carefully manage the dispersal of patients transported by ambulance in a manner to avoid overcrowding problems in the surrounding Emergency Departments.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.