1 0 0 0 OA 多職種連携による肝炎ウイルス陽性者拾い上げ活動の効果
- 著者
- 藤原 美子 瓦谷 英人 藤井 智津子 和田 和美 岡田 世佳 久保 卓也 赤羽 たけみ 簗瀬 公嗣 仲川 喜之
- 出版者
- 一般社団法人 日本肝臓学会
- 雑誌
- 肝臓 (ISSN:04514203)
- 巻号頁・発行日
- vol.64, no.10, pp.487-496, 2023-10-01 (Released:2023-10-12)
- 参考文献数
- 15
2019年から肝炎医療コーディネーター(肝Co)活動による肝炎ウイルス陽性者の拾い上げを開始した.2019年から2021年までは肝炎ウイルス(HBV,HCV)陽性者に対して検査依頼医へ電子カルテのアラート機能を用いたメッセージ記載による専門医への受診勧奨が主な取り組みであった.しかし,検査結果を伝えられていないHCV陽性者は2019年の52.5%(32/61)から2021年は26.7%(12/45)と減少したものの,0%とならず新たな対策が必要と考えた.2022年に多職種で構成された「肝炎対策チーム」を立ち上げ,肝炎ウイルス陽性者確認後の流れを明確にした「フローチャート」を作成し拾い上げ活動を強化した.その結果,HCV陽性者に検査結果が伝わっていない症例は,2022年には5.3%(3/57)と著減した.「フローチャート」を軸とした肝Co活動は,多職種連携により効果的に機能したと考える.
1 0 0 0 OA 肩甲骨骨折の治療成績 ―肩甲帯部合併損傷の取り扱い―
- 著者
- 仲川 喜之 梅垣 修三 尾崎 二郎 富田 恭治 中垣 公男 桜井 悟良 松倉 光晴 建道 寿教
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.18, no.1, pp.110-115, 1994-09-01 (Released:2012-11-20)
- 参考文献数
- 5
- 被引用文献数
- 1
The purpose of this report is to evaluate the results of treatment for fractures of the scapula with associated injuries. This study was composed of 123 patients (130 fractures). One hundred and seven were males and 16 were fenales. Their average age was 44.8 ranging from 3 to 84. The fractures were divided into four types as follows; scapular body: 54 cases, scapular neck: 40 cases, coracoid process: 18 cases, acromion or scapular spine: 18 cases. Seven cases had fractures in more than one location. Eighty-one of the 123 cases (66%) had assoceated injuries. Ninety-four cases were treated conservatively and 29 cases surgically. The results of the treatment were evaluated by the J.O.A.score.The results of cases without any nerve injuries were judged as excellent (mean score of conservative cases: 92.3 points, surgical cases: 97.1 poinys). Cases with nerve injuries had poor results (mean score of the conservative cases: 80.3 points, surgical cases: 85.7 points).An association between scapular fractures and fractures of the ribs is common. In those cases, a pneumothorax may not develop immediately after a traumatic episide, but it may occur after a few days. An acromioclavicular dislocation is apt to be associated with a fracture of the coracoid process, in which case, surgical treatment is indicated. A displaced fracture of the scapular neck associated with a clavicular fracture on the same side is unstable, in which case, surgical treatment is indicated. A rotator cuff tear is apt to be associated with a fracture of the scapular body or but it is often overlooked, Associated nerve injuries have a great inflvence on the results. It is important to examine an associated nerve imjury and to start rehabilitation as soon as possible. neck, very
1 0 0 0 OA 肩甲下筋腱断裂の病態
- 著者
- 尾崎 二郎 仲川 喜之 増原 建二
- 出版者
- 日本肩関節学会
- 雑誌
- 肩関節 (ISSN:09104461)
- 巻号頁・発行日
- vol.12, no.2, pp.211-213, 1988-08-10 (Released:2012-11-20)
- 参考文献数
- 6
Twelve cases with isolated tear of the subscapularis tendon were observed during 250reconstructive procedures on the rotator cuff. The patients' age was 51.6 years on average. All of the patients had a definite history of trauma to an affected shoulder and persistent pain in the anterior shoulder part, combined with the inability to evevate the extremity. Arthrography was performed on all, and revealed that the dye had extravasated into the subacromial bursa, however, the supraspinatus tendon was intact on the external rotation view. Operative findings revealed that an isolated rupture of the subscapularis tendon was confirmed in all. In 10 cases with rupture of the supero-medial part of the subscapularis tendon, medial dislocation of the bicipital long tendon was observed. Therefore, the authors conclude that the supero-medial part of the subscapularis tendon, including the medial bundle of the coracohumeral ligament, is the most important portion which keeps the bicipital long tendon aligned with the sulcus, and that during reconstructive procedures on the shoulder capsule, these changes should be carefully looked for and evaluated.