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An Official Journal of the Japan Primary Care Association最新文献

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Smaller Superior Mesenteric Vein Sign Indicating Superior Mesenteric Artery Dissection 较小的肠系膜上静脉征象表明肠系膜上动脉夹层
An Official Journal of the Japan Primary Care Association Pub Date : 2022-12-20 DOI: 10.14442/generalist.45.141
Junki Mizumoto
{"title":"Smaller Superior Mesenteric Vein Sign Indicating Superior Mesenteric Artery Dissection","authors":"Junki Mizumoto","doi":"10.14442/generalist.45.141","DOIUrl":"https://doi.org/10.14442/generalist.45.141","url":null,"abstract":"特に既往歴のない 53歳男性が,5時間前に急性に発 症した腹部全体痛のため小病院の夜間救急外来を来院 した.持続的で刺すような痛みであり,徐々に増悪し ていた.身体診察では血圧高値(168/106 mm Hg)と 心窩部の軽度圧痛があった.血液検査の有意所見は軽 度の白血球数増多のみであった.腹部単純 CT撮影で は,上腸間膜静脈(SMV)の径が 6.7 mmと,上腸間膜 動脈(SMA)の 8.4 mmと比べ小さかった(図 1A). この所見はこの時点では気づかれなかった.患者は急 性胃炎の暫定診断のもと,鎮痛薬の処方を受け,帰宅 した.その 4時間後,疼痛がさらに増悪したため患者 は再度来院した.バイタルサインに特記すべき変化は なかった.増悪する持続痛であり,SMA解離を念頭に CT画像が見直され,smaller SMV signが発見された. 造影 CTでは SMAの単独解離が明らかとなった(図 1B-1D).腸管虚血を疑う臨床および検査所見はなく, 降圧と鎮痛による保存的入院加療で良好な経過が得ら れ,患者は 8日後に退院した. SMA解離は非特異的な症状を呈し,胃炎や腸炎と 誤診されやすい.画像検査が診断に有用であるが,造 影 CTであっても所見はよく見逃される. Smaller SMV signは,低灌流による SMVの虚脱, または急性 SMA閉塞による SMAの拡張でみられ る.急性 SMA閉塞における本徴候の感度は 70%,特 異度は 99.2%と報告されている.SMA解離と smaller SMV signの関係を直接示した報告は少なく,本例で は,血流低下による SMVの虚脱という機序と,解離腔 内の血栓形成による SMA径の拡張という機序が考え られる.SMA解離の診断例において,単純 CTは造 影 CTと同程度に撮影されており,単純 CTで分かる smaller SMV signは診断の手掛かりとなりうる.読影 の際は,腎の上半分が描出され SMAと SMVが並列 する水平断画像で,各血管の最小径を比較する. 本例では,SMA解離が疑われるまで本徴候は見落 とされていた.SMA解離では患者の主観的な症状が 身体診察所見と乖離することがある.持続する腹痛患 者では,smaller SMV signに注目することで急性 SMA閉塞・狭窄症の見逃しが減る可能性がある.","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125750345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Report on Four-year Activities of a Multidisciplinary Polypharmacy Response Team at a Regional Core Hospital 关于区域核心医院多学科综合药物反应小组四年活动的报告
An Official Journal of the Japan Primary Care Association Pub Date : 2022-12-20 DOI: 10.14442/generalist.45.132
Masahiro Kitajima, T. Aoki, Masato Uchida, Takashi Namura, Masako Okuda, Tadayuki Hashimoto
{"title":"Report on Four-year Activities of a Multidisciplinary Polypharmacy Response Team at a Regional Core Hospital","authors":"Masahiro Kitajima, T. Aoki, Masato Uchida, Takashi Namura, Masako Okuda, Tadayuki Hashimoto","doi":"10.14442/generalist.45.132","DOIUrl":"https://doi.org/10.14442/generalist.45.132","url":null,"abstract":"はじめに ポリファーマシーという言葉が使われるようになっ たのは 150年以上前であるが,多くの研究者は,ポリ ファーマシーが 21世紀で最も困難な公衆衛生問題の 1つになり得ると考えている.最近の研究では,米国 の 65歳以上の高齢者の約 39%が 5種類以上の薬を服 用しており,長崎県のデータでは 85歳以上の高齢者 の半数が 6種類以上の薬を処方されていた. 薬の数の増加によって引き起こされる問題は副作用 や相互作用だけでなく,医療ミス,生活の質の低下, 患者や社会の医療に対する経済的負担の増大など多岐 にわたる.ポリファーマシーに関する研究は数多くあ り,介入の評価を含めた研究は年々増加している.日 本でも「高齢者の安全な薬物療法ガイドライン 2015」 が策定されたが,個々の薬への対策が中心であり,ポ リファーマシーへ効果的に対応する方法については, コンセンサスが得られていないのが現状である.","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125968637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Longitudinal Study on the Perceptions of the Okayama University Reinstatement Support System and System Users among Doctors: A Comparison between FY2011 and FY2018 冈山大学医生对康复支持系统及系统使用者认知的纵向研究:2011财年与2018财年比较
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.82
Mayu Watanabe, Chikako Fujii, A. Tokinobu, Taeko Mizoo, H. Ogawa, Hitomi U. Kataoka
{"title":"A Longitudinal Study on the Perceptions of the Okayama University Reinstatement Support System and System Users among Doctors: A Comparison between FY2011 and FY2018","authors":"Mayu Watanabe, Chikako Fujii, A. Tokinobu, Taeko Mizoo, H. Ogawa, Hitomi U. Kataoka","doi":"10.14442/generalist.45.82","DOIUrl":"https://doi.org/10.14442/generalist.45.82","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"152 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114061693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Establishing a Regional Medical Cooperation Network in a Mountainous Area Using an Information Sharing Application Developed by Reflecting the Opinions of Medical and Welfare Professionals 利用反映医疗福利专业人员意见开发的信息共享应用建立山区区域医疗合作网络
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.102
Takeshi Tanaka, Koichi Yamaguchi, Kazuoki Inoue, Daisuke Son, Masahiko Koda, Shin-ichi Taniguchi
{"title":"Establishing a Regional Medical Cooperation Network in a Mountainous Area Using an Information Sharing Application Developed by Reflecting the Opinions of Medical and Welfare Professionals","authors":"Takeshi Tanaka, Koichi Yamaguchi, Kazuoki Inoue, Daisuke Son, Masahiko Koda, Shin-ichi Taniguchi","doi":"10.14442/generalist.45.102","DOIUrl":"https://doi.org/10.14442/generalist.45.102","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115431340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Activities Report of a COVID-19 Response Team in Shizuoka 静冈县新冠肺炎疫情应对小组活动报告
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.93
H. Kurai, Aiko Yoshida
{"title":"Activities Report of a COVID-19 Response Team in Shizuoka","authors":"H. Kurai, Aiko Yoshida","doi":"10.14442/generalist.45.93","DOIUrl":"https://doi.org/10.14442/generalist.45.93","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"272 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124256203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Co-management of the Neurosurgery Department by General Physicians 全科医师共同管理神经外科的效果
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.74
Hiroyuki Yamamoto, Kentaro Kameda, M. Komatsu, Takeshima Yoshihiro, Shouhei Noshiro, M. Ohtaki
{"title":"Effects of Co-management of the Neurosurgery Department by General Physicians","authors":"Hiroyuki Yamamoto, Kentaro Kameda, M. Komatsu, Takeshima Yoshihiro, Shouhei Noshiro, M. Ohtaki","doi":"10.14442/generalist.45.74","DOIUrl":"https://doi.org/10.14442/generalist.45.74","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129618288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ambulatory Training of Patients with Dementia in a General Internal Medicine Department Conducted by Residents from a University Hospital and Instructors from a Psychiatric Hospital 大学医院住院医师与精神病院指导员对普通内科痴呆患者的门诊训练
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.90
Yusuke Matsuzaka, A. Nagatani, H. Hamada, Toshihiro Otsuka, Hiroki Ozawa
{"title":"Ambulatory Training of Patients with Dementia in a General Internal Medicine Department Conducted by Residents from a University Hospital and Instructors from a Psychiatric Hospital","authors":"Yusuke Matsuzaka, A. Nagatani, H. Hamada, Toshihiro Otsuka, Hiroki Ozawa","doi":"10.14442/generalist.45.90","DOIUrl":"https://doi.org/10.14442/generalist.45.90","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125258919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Fitness to Drive Assessment Program at Family Physicians' Clinic in Japan 日本家庭医生诊所的健康驱动评估项目
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.97
Mamiko Ukai, Tadao Okada, Takuya Higashi, Yusuke Kanakubo, Ryota Takahashi
{"title":"The Fitness to Drive Assessment Program at Family Physicians' Clinic in Japan","authors":"Mamiko Ukai, Tadao Okada, Takuya Higashi, Yusuke Kanakubo, Ryota Takahashi","doi":"10.14442/generalist.45.97","DOIUrl":"https://doi.org/10.14442/generalist.45.97","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131412964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
多様性，少子化，そして働き方 多样性、少子化和工作方式
An Official Journal of the Japan Primary Care Association Pub Date : 2022-09-20 DOI: 10.14442/generalist.45.73
英樹 野村
{"title":"多様性，少子化，そして働き方","authors":"英樹 野村","doi":"10.14442/generalist.45.73","DOIUrl":"https://doi.org/10.14442/generalist.45.73","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133105450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Report: The 12th Annual Conference of Japan Primary Care Association Career Café: Online Career Counselling Room 报告:第12届日本初级保健协会职业研讨会:在线职业咨询室
An Official Journal of the Japan Primary Care Association Pub Date : 2022-06-20 DOI: 10.14442/generalist.45.69
Atsushi Kaku
{"title":"Report: The 12th Annual Conference of Japan Primary Care Association Career Café: Online Career Counselling Room","authors":"Atsushi Kaku","doi":"10.14442/generalist.45.69","DOIUrl":"https://doi.org/10.14442/generalist.45.69","url":null,"abstract":"","PeriodicalId":211485,"journal":{"name":"An Official Journal of the Japan Primary Care Association","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134014648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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